Response of Proliferative Lupus Nephritis with Pulse Cyclophosphamide Therapy during Induction Period: A Single Centre Study in Bangladesh.

This prospective study was conducted to assess the response of proliferative lupus nephritis with pulse cyclophosphamide therapy during induction period in the department of Nephrology of Dhaka Medical College, Dhaka, Bangladesh from December 2012 to November 2013. A total of 35 clinically diagnosed SLE patients of class III/IV lupus nephritis were included. But 3 patients were dropped out during follow-up, therefore finally 32 patients (class III = 4, class IV = 28) were studied. The patients were evaluated for response on the basis of proteinuria, serum creatinine & active sediment in urine after 6th cycle of cyclophosphamide and 62.5% patients achieved complete response, 25% patients achieved partial response & 12.5% patients achieved no response. The factors favored complete response was early clinical presentation (7 months duration), proteinuria ≤3gm/day& normal renal function during their initial presentation. And higher anti ds DNA titre was an independent predictor for partial response/no response.

Effect of point mutations on the ultrafast photo-isomerization of Anabaena sensory rhodopsin.

Anabaena sensory rhodopsin (ASR) is a particular microbial retinal protein for which light-adaptation leads to the ability to bind both the all-trans, 15-anti (AT) and the 13-cis, 15-syn (13C) isomers of the protonated Schiff base of retinal (PSBR). In the context of obtaining insight into the mechanisms by which retinal proteins catalyse the PSBR photo-isomerization reaction, ASR is a model system allowing to study, within the same protein, the protein-PSBR interactions for two different PSBR conformers at the same time. A detailed analysis of the vibrational spectra of AT and 13C, and their photo-products in wild-type ASR obtained through femtosecond (pump-) four-wave-mixing is reported for the first time, and compared to bacterio- and channelrhodopsin. As part of an extensive study of ASR mutants with blue-shifted absorption spectra, we present here a detailed computational analysis of the origin of the mutation-induced blue-shift of the absorption spectra, and identify electrostatic interactions as dominating steric effects that would entail a red-shift. The excited state lifetimes and isomerization reaction times (IRT) for the three mutants V112N, W76F, and L83Q are studied experimentally by femtosecond broadband transient absorption spectroscopy. Interestingly, in all three mutants, isomerization is accelerated for AT with respect to wild-type ASR, and this the more, the shorter the wavelength of maximum absorption. On the contrary, the 13C photo-reaction is slightly slowed down, leading to an inversion of the ESLs of AT and 13C, with respect to wt-ASR, in the blue-most absorbing mutant L83Q. Possible mechanisms for these mutation effects, and their steric and electrostatic origins are discussed.

Outcome of Pregnancy Related Acute Kidney Injury Observed in a Tertiary Care Hospital.

This prospective case control study was carried out in Mymensingh Medical College Hospital (MMCH) from April 2011 to March 2012. The main objective of the study was to determine the short term maternal outcome of pregnancy related Acute Kidney Injury and to identify aetiological factors and to observe clinical features of pregnancy related Acute Kidney Injury. Total 60 pregnant women with AKI were included in the study as sample and equal (60) number of pregnant women with normal renal function was taken as control. Mean ages (±SD) of study and control group were observed 31.6±6.9 years and 25.5±4.7 years respectively. It was observed that most patients were from rural area with low income group. Most women were multiparous and presented in third trimester and postpartum period. Majority of the study subjects did not receive antenatal care at any stage of pregnancy. Fifty (86.7%) of the study subjects were oligo-anuric, forty-nine (81.7%) were edematous and fifty one (85%) were anaemic. Twenty-five (41.7%) patients presented with abnormal vaginal bleeding. Sepsis (including septic abortion and puerperal sepsis) was responsible for of Pregnancy Related AKI (PR-AKI) in more than two fifths of cases. Haemorrhage (APH & PPH combined) was the next common cause of Pregnancy Related AKI (PR-AKI). Toxemia of Pregnancy was responsible in one fourth of cases. Dialysis (HD & IPD combined) was required for two fifths of the patients. Rest patients were treated conservatively with antibiotics, blood transfusion, maintenance of fluid and electrolytes balance etc. Maternal outcome of Pregnancy related acute kidney injury was considered for the period of patient's hospital staying. 56.6% patients recovered completely, 15.0% patients recovered partially, 6.7% did not recover at the time of hospital discharge; while 21.7% died. So it can be concluded that, pregnancy related acute kidney injury is a critical condition, associated with worse prognosis.

Thyrolingual trunk arising from the common carotid bifurcation.

Carotid arteries and their branches exhibit a wide range of variations. However, variations in the origin of the thyrolingual trunk from the common carotid artery are rare. We observed a case of thyrolingual trunk arising from the bifurcation point of the right common carotid artery during a routine dissection class for medical undergraduates. The thyrolingual trunk was running medially and downward before dividing into the upper lingual artery and the lower superior thyroid artery. No such variation was noted from the bifurcation point of the left common carotid artery.

Mediastinal teratoma mimicking massive pleural effusion.

Immature mediastinal teratoma is very rare, found in only 1% of all mediastinal teratomas. Raised serum alpha feto-protein acts as important surrogate marker for both diagnosis and follow up in such cases. Surgery and adjuvant chemotherapy are keys in the management, especially in patients older than 15 years of age. We present a 14-year-boy presenting clinico-radiologically as left sided massive pleural effusion. Raised serum marker as well as excision biopsy of the mediastinal mass following thoracotomy were indicative of a diagnosis of immature teratoma.

QSPR of the bioconcentration factors of non-ionic organic compounds in fish using extended topochemical atom (ETA) indices.

Bioconcentration refers to the absorption or uptake of a chemical from the media to an organism's tissues leading to greater concentration in tissues than that in the surrounding environment. Considering the importance of bioconcentration from the viewpoint of ecological safety assessment, a QSPR study was conducted based upon log BCF of 122 non-ionic organic compounds in fish using the recently introduced extended topochemical atom (ETA) indices. In deriving the models, principal component factor analysis (FA) followed by multiple linear regression (MLR), stepwise regression, partial least squares (PLS) and principal component regression analysis (PCRA) were applied as statistical tools. This was repeated with non-ETA (topological and physicochemical) descriptors and a combination set including both the ETA and non-ETA descriptors. The ETA indices suggested negative contributions of functionalities of nitro, amino and hydroxy substructures and positive contributions of branching, volume and functionality of chloro substituents. Again, the predictive ability of the developed models was compared with the previously reported models. Finally the validation of all the QSAR models was discussed based on random division, sorted log BCF data and K-means clusters for the factor scores of the original variable (ETA) matrix without the response property values. The results suggest that ETA parameters are sufficiently rich in chemical information to encode the structural features contributing to the bioconcentration of the non-ionic organic compounds in fish and thus these merit further assessment to explore their potential in QSAR/QSPR/QSTR modelling.

A rare H-type of tracheo-oesophageal fistula in a young boy.

A 9-year-old male child presented with features of recurrent episodes of pneumonia. Following administration of different types of antibiotics, resolution of pneumonia was not complete. Antituberculous drugs were given on two occasions for sufficient period of time without any improvement. Following admission, history of a choking sensation during taking food pointed to perform barium swallow examination of oesophagus which revealed the diagnosis of tracheo-oesophageal fistula.

Diagnosis of tuberculosis.

Presence of tuberculous infection in the body does not necessarily mean disease. Any diagnostic work up of the disease starts from a high index of clinical suspicion. However, diagnostic modalities include: (a) Isolation of the bacillus; (b) Immunologic tests; (c) Chemical markers; (d) FNAC, bronchoscopy and bronchoalveolar lavage; (e) Amplification systems. There exists controversies and limitations about the disease process even then.

Osteoid osteoma of the hallux.

A case involving a 29-year-old female with aspirin allergy who exhibited osteoid osteoma at the distal phalanx of the hallux is presented. Osteoid osteoma is a relatively rare occurrence in the foot (1). It is a benign bone tumor usually consisting of an oval osteolytic area with a central nidus (2). Pathologic, clinical, and radiographic findings are included.