RESUMEN
Chikungunya virus (CHIKV) is a re-emerging pathogen of global importance. We attempted to gain an insight into the organisation, distribution and mutational load of the virus strains reported from different parts of the world. We describe transmission dynamics and genetic characterisation of CHIKV across the globe during the last 65 years from 1952 to 2017. The evolutionary pattern of CHIKV was analysed using the E1 protein gene through phylogenetic, Bayesian and Network methods with a dataset of 265 sequences from various countries. The time to most recent common ancestor of the virus was estimated to be 491 years ago with an evolutionary rate of 2.78 × 10-4 substitutions/site/year. Genetic characterisation of CHIKV strains was carried out in terms of variable sites, selection pressure and epitope mapping. The neutral selection pressure on the E1 gene of the virus suggested a stochastic process of evolution. We identified six potential epitope peptides in the E1 protein showing substantial interaction with human MHC-I and MHC-II alleles. The present study augments global epidemiological and population dynamics of CHIKV warranting undertaking of appropriate control measures. The identification of epitopic peptides can be useful in the development of epitope-based vaccine strategies against this re-emerging viral pathogen.
Asunto(s)
Fiebre Chikungunya , Virus Chikungunya , Epidemias , Fiebre Chikungunya/epidemiología , Fiebre Chikungunya/historia , Fiebre Chikungunya/transmisión , Fiebre Chikungunya/virología , Virus Chikungunya/clasificación , Virus Chikungunya/genética , Epítopos de Linfocito B/genética , Evolución Molecular , Salud Global , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Filogenia , Proteínas del Envoltorio Viral/genéticaRESUMEN
A neural field model of the corticothalamic system is applied to investigate the temporal and spectral characteristics of absence seizures in the presence of a temporally varying connection strength between the cerebral cortex and thalamus. Increasing connection strength drives the system into an absence seizure-like state once a threshold is passed and a supercritical Hopf bifurcation occurs. The dynamics and spectral characteristics of the resulting model seizures are explored as functions of maximum connection strength, time above threshold, and the rate at which the connection strength increases (ramp rate). Our results enable spectral and temporal characteristics of seizures to be related to changes in the underlying physiological evolution of connections via nonlinear dynamics and neural field theory. Spectral analysis reveals that the power of the harmonics and the duration of the oscillations increase as the maximum connection strength and the time above threshold increase. It is also found that the time to reach the stable limit-cycle seizure oscillation from the instability threshold decreases with the square root of the ramp rate.
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Corteza Cerebral/fisiología , Modelos Neurológicos , Convulsiones/patología , Convulsiones/fisiopatología , Tálamo/fisiología , Simulación por Computador , Progresión de la Enfermedad , Sincronización de Fase en Electroencefalografía/fisiología , Epilepsia Tipo Ausencia/patología , Epilepsia Tipo Ausencia/fisiopatología , Epilepsia Tipo Ausencia/psicología , Humanos , Dinámicas no Lineales , Convulsiones/psicologíaRESUMEN
Dengue fever is an arthropod-borne viral infection that has become endemic in several parts of India including Delhi. We studied occurrence of co-infection with dengue viruses during an outbreak in New Delhi, India in 2014. For the present study, blood samples collected from symptomatic patients were analysed by RT-PCR. Eighty percent of the samples were positive for dengue virus. The result showed that DENV-1 (77%) was the predominant serotype followed by DENV-2 (60%). Concurrent infection with more than one serotype was identified in 43% of the positive samples. Phylogenetic analysis clustered DENV-1 strains with the American African and DENV-2 strains in Cosmopolitan genotypes. Four common amino-acid mutations were identified in the envelope gene of DENV-1 sequences (F337I, A369T, V380I and L402F) and one common mutation (N390S) in the DENV-2 sequences. Further analysis revealed purifying selection in both the serotypes. A significant number of patients were co-infected with DENV-1 and DENV-2 serotypes. Although we do not have direct evidence to demonstrate co-evolution of these two stereotypes, nonetheless their simultaneous occurrence does indicate that they are favoured by evolutionary forces. An ongoing surveillance and careful analysis of future outbreaks will strengthen the concept of co-evolution or otherwise. Whether the concurrent dengue viral infection is correlated with disease severity in a given population is another aspect to be pursued. This study is envisaged to be useful for future reference in the context of overall epidemiology.
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Coinfección/epidemiología , Coinfección/virología , Virus del Dengue/clasificación , Virus del Dengue/aislamiento & purificación , Dengue/epidemiología , Dengue/virología , Brotes de Enfermedades , Adulto , Sustitución de Aminoácidos , Análisis por Conglomerados , Virus del Dengue/genética , Femenino , Genotipo , Humanos , India/epidemiología , Masculino , Mutación Missense , Filogenia , Serogrupo , Proteínas del Envoltorio Viral/genética , Adulto JovenRESUMEN
The present environmental study has been planned to investigate the toxic effects of arsenic on reproductive functions of Teddy bucks as well as to examine whether these toxic effects are ameliorated by vitamin E. Sixteen adult Teddy bucks were divided randomly into four equal groups A, B, C and D with following treatment: A (control), B (sodium arsenite 5 mg kg-1 BW day-1 ), C (vit E 200 mg kg-1 BW day-1 + Arsenic 5 mg kg-1 BW day-1 ) and D (vit E 200 mg kg-1 BW day-1 ). This treatment was continued for 84 days. Semen quality parameters were evaluated weekly. Male testosterone, luteinising hormone (LH), follicle-stimulating hormone (FSH) and cortisol levels were measured through enzyme-linked immunosorbent assay (ELISA) after every 2 weeks. The data were subjected to two-way analysis of variance followed by Duncan test for multiple comparisons. Semen evaluation parameters were reduced significantly (P < 0.05) in arsenic-treated animals. The serum hormonal profile of testosterone, LH and FSH was reduced significantly (P < 0.05) in arsenic group, while the serum level of cortisol was increased. Vitamin E alleviated the toxic effects of arsenic on semen and hormonal parameters. It may be concluded from this study that sodium arsenite causes major toxicity changes in semen and hormonal profile in Teddy goat bucks and vitamin E has ameliorative effects on these toxic changes.
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Arsenitos/toxicidad , Hormona Folículo Estimulante/sangre , Hidrocortisona/sangre , Hormona Luteinizante/sangre , Semen/efectos de los fármacos , Compuestos de Sodio/toxicidad , Testosterona/sangre , Vitamina E/farmacología , Animales , Ensayo de Inmunoadsorción Enzimática , Cabras , Masculino , Análisis de Semen , Testículo/efectos de los fármacosRESUMEN
This case-control study was done to find out whether elevated serum CRP in early pregnancy is a predictor of GDM and conducted under joined supervision of Obstetrics & Gynecology Department, Bangabandhu Sheikh Mujib Medical University (BSMMU) Hospital and Biomedical Research Group (BMRG), BIRDEM, from August 2005 to November 2007. Pregnant mothers at their first 16 weeks of gestation without any medical disorder of pregnancy were included in the study. For the purpose of this study blood samples were again collected for OGTT at their 16weeks, 24-28 weeks and 32 weeks of pregnancy to detect GDM. After confirmation of GDM, C-reactive protein and C-peptide were done from the preserved fasting serum sample at the end of this study to compare GDM with control group. A total of 297 patients were included in this study. Among them 145(48%) patients completed follow up, 59(20%) lost from follow-up and 11(4%) patients had abortion; 82(28%) are due for follow up 31(10%) pregnant patients developed GDM subsequently. Finally 28 GDM patients were taken as cases and 71 were control matched for their gestational age and parity. At earlier weeks of gestation, hsCRP could predict (PPV) development of GDM in 59% with NPV 84%, sensitivity 61% and specificity 83%. C-peptide in the 50th percentile could predict (PPV) development of GDM in 58% with NPV 96%, sensitivity 72% and specificity 93%. The present data indicates that hsCRP and C-peptide both is sensitive markers in predicting GDM.
Asunto(s)
Proteína C-Reactiva/análisis , Diabetes Gestacional/diagnóstico , Adolescente , Adulto , Bangladesh , Estudios de Casos y Controles , Diabetes Gestacional/etiología , Femenino , Edad Gestacional , Humanos , Paridad , Embarazo , Adulto JovenRESUMEN
This prospective multi-centre study was carried out in the Department of obstetrics and gynaecology of Bangabandhu Sheikh Mujib Medical University, Dhaka Medical College Hospital and Bangladesh Medical College Hospital, Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh, during the period of January 2008 to December 2009, to establish the raised level of serum LDH and serum CA-125 in pre-operative discrimination of benign and malignant ovarian cancer to be used as a diagnostic marker and its validity by determining sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPP). A total number of 141 consecutive suspected subjects of ovarian tumour admitted in the above mentioned hospitals and enrolled for surgical management were included in this study. Serum LDH was done in all these subjects and they were followed up from the admission upto the postoperative tissue diagnosis of live tumor in respective pathology departments for histopathological correlation. The patients who were diagnosed as malignant placed in Group I and diagnosed benign ovarian tumor placed in Group II. Serous cystadenoma and mucinous cyst adenoma were more common in benign tumors, which were 38.9% and 20.4% respectively. However, more than a half (57.1%) had serous cyst adenocarcinoma in malignant tumors. In LDH for evaluation of malignancy, true positive 16 and false positive 18, false negative 12 and true negative 95 cases. LDH and serum CA-125 level (combined, i.e. both positive) for evaluation of malignancy, true positive 14 and false positive 0, false negative 14 and true negative 113 cases. LDH/serum CA-125 level (anyone positive) for evaluation of malignancy, true positive 25 and false positive 37, false negative 3 and true negative 76 cases. The validity of LDH were sensitivity 57.1%, specificity 84.1%, accuracy 78.7%, positive predictive values 47.1% and negative predictive values 88.8% for malignancy of ovarian tumour. The validity of CA-125 were sensitivity 78.6%, specificity 82.3%, accuracy 81.6%, positive predictive values 52.4% and negative predictive values 93.9% for malignancy of ovarian tumour. The validity of LDH and serum CA-125 level (combined, i.e. both positive) for malignant ovarian tumour it was found that sensitivity 50.0%, specificity 100.0%, accuracy 90.1%, positive predictive values 100.0% and negative predictive values 89.0%.
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Neoplasias Ováricas , Bangladesh , Antígeno Ca-125 , Femenino , Humanos , Estudios ProspectivosRESUMEN
Infertility is an important health issue which has been neglected in the developing countries. First test-tube babies (triplet) in Bangladesh were born on 30th May, 2001. Although there is no tertiary level infertility center in the public sector, several private centers have come up with the facilities. The objective of the study was to find i) the quality and quantity of infertility care in Bangladesh and ii) the cause of infertility in the attending patients iii) the treatment seeking behaviors iv) and the reasons for not taking treatment among the attending patients. There are now 10 tertiary level Infertility centers in Bangladesh. The information was collected in a preformed datasheet about the facilities and the profile of the patients and the treatment seeking behavior of the attending patients. Out of the ten centers two centers refused to respond and did not disclose their data. Around 16700 new patients are enrolled in a year in the responsive clinics. Five percent (5%) of the patients underwent ART, 7% of the patients gave only one visit, 84% of the patients completed their evaluation, 76% of the patients took treatment. Causes of infertility in the patients taking treatment were male factor in 36.4%, bilateral tubal block in 20.2%, PCOS and anovulation in 31.7%, endometriosis in 19.6%, unexplained in 10.95, combined in 3.5%, ovarian failure in 1.4%, testicular failure in 0.33%, congenital anomaly in 0.3%. The main reason for not taking treatment was financial constrainment. The quality and quantity of infertility care is dependent on the available resources and on the use of the resources by the patients. In developing countries the resources are merging and confined to specified areas which cannot meet the demand of their population. The study gives us the idea of the need and the demand of the services in the country.
Asunto(s)
Infertilidad/terapia , Calidad de la Atención de Salud , Bangladesh , Femenino , Humanos , Masculino , Técnicas Reproductivas AsistidasRESUMEN
In developing countries, abdominal myomectomy is still a modality of treatment for large and symptomatic uterine fibroid in women who wish to retain their fertility and preserve uterus. In order to assess the outcome of pregnancies after myomectomy, a prospective observational study was carried out in the Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from July 1999 and June 2011. Study included 40 married women of reproductive age, suffering either from primary or secondary subfertility, and who had uterine fibroid and strongly wished to conceive shortly after myomectomy using microsurgical procedure with no existence of other male and female subfertility factor. These women were followed up at 3, 6, 12 and 24 month intervals over telephone and outdoor visits. Data were recorded on preformed questionnaires. Post myomectomy hysterosalpingography was done at about 16 weeks after myomectomy. Patients were advised to try for pregnancy after 16 weeks of operation. Maximum number of women belonged to age group 31-35 years (n=14, 35%); primary subfertility was 67.5% and secondary 32.5%; in maximum number of cases duration of subfertility was 2-5 years (n=22, 55%); type of fibroid were solitary (52.5%) and multiple (47.5%); type of myoma were intramural (75%), submucous (2.5%) and combined (22.5%); location of myoma were fundal (5%), anterior wall (25%), posterior wall (20%) and combined (50%); diameter of removed myoma were <5cm (2.5%), 5-8cm (67.5%), >8-10(20%) and >10cm (10%); uterine size before myomectomy were (in weeks) <12(22.5%), 12-14 (27.5%), 15-20 (32.5%), 21-25 (15%) and >25 (2.5%). Hysterosalpingography was done in 16(40%) cases, and the findings were both tube patent (62.5%), unilateral tubal block (31.2%) and bilateral tubal block (6.2%). Menorrhagia after myomectomy was present only in 5% cases. After uterine myomectomy, 14(35%) women conceived, common time interval between myomectomy and conception was 1-2 years (42.9%), conception was spontaneous in 71.4%. Out of 14 who conceived after myomectomy 12(85.7%) delivered live babies by LUCS, and most of the babies weighed >3kg (58.3%).
Asunto(s)
Leiomioma/cirugía , Complicaciones Neoplásicas del Embarazo/cirugía , Neoplasias Uterinas/cirugía , Adulto , Femenino , Humanos , Recién Nacido , Embarazo , Resultado del EmbarazoRESUMEN
Polycystic ovarian syndrome (PCOS) has a pivotal role in the development of various complications during pregnancy. Polycystic ovarian syndrome women having elevated LH and hyper insulineuia may be at increased risk of miscarriage. The study was done to find out the recurrent pregnancy loss among the PCOS patient. This was a cross sectional case control study in total 100 infertile patients between age 20-40 years attending BSMMU out patient Department from July 2011 to June 2012, among them 50 infertile patients with PCOS regarding as a case and 50 infertile patients without PCOS selected as a control. Regarding case (infertile patients with PCOS) shows 20(40%) recurrent miscarriage and among control (infertile patients without PCOS) shows recurrent miscarriage 6(12%). And also among case group shows insulin resistance 8(16%) and control group insulin resistance 1(2%). Six (75%) abortion occur among PCOS with insulin resistance and 5(62.5%) abortion occur among PCOS with raised testosterone level. It is observed that recurrent miscarriage is higher in PCOS group. And also concluded that insulin resistance and raised testosterone level is responsible for this condition. So, further large scale study would be needed to reduce the chance of recurrent pregnancy loss by treatment with insulin sensitizer in case of obese PCOS with insulin resistance patient.
Asunto(s)
Aborto Habitual , Resistencia a la Insulina , Obesidad/complicaciones , Síndrome del Ovario Poliquístico , Aborto Habitual/sangre , Aborto Habitual/epidemiología , Aborto Habitual/etiología , Aborto Habitual/prevención & control , Adulto , Bangladesh/epidemiología , Estudios de Casos y Controles , Estudios Transversales , Femenino , Humanos , Infertilidad Femenina , Insulina/orina , Síndrome del Ovario Poliquístico/sangre , Síndrome del Ovario Poliquístico/complicaciones , Síndrome del Ovario Poliquístico/epidemiología , Embarazo , Testosterona/sangreRESUMEN
Although vitamin D deficiency is one of the most common health problems throughout the world, conflicting information exists on the potential association between serum vitamin D levels and semen quality. Currently available data identifies that vitamin D has a vital role in reproductive process as it affects sperm motility. This study was done with the rationality to evaluate the association between serum vitamin D levels with asthenozoospermic males. This cross-sectional analytic study was conducted on 314 men who attended the Department of Reproductive Endocrinology and Infertility, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh July 2018 to June 2019. Considering the inclusion and exclusion criteria all participants were categorized into two groups; Group I included 157 asthenozoospermic male and Group II included 157 normozoospermic male according to World Health Organization 'strict' criteria 2010. Participants completed the questionnaires after they had agreed on a informed consent. Blood and semen samples were obtained for assessment and all data were adjusted for age, body mass index (BMI), total motility and progressive motility. Vitamin D levels were classified according to the Endocrine Society guideline. Statistical analyses were carried out by using the Statistical Package for Social Sciences version 22.0 for Windows (SPSS Inc., Chicago, Illinois, USA). The results showed that the mean vitamin D level was 16.63±5.54ng/ml in asthenozoospermic group and 19.83±5.33ng/ml in normozoospermic group. The mean vitamin D level was significantly (p<0.05) lower in asthenozoospermic group. It was noticed that 86.6% patients had vitamin D deficiency (≤20ng/ml) in asthenozoospermic group compared to 56.7% in the normozoospermic group. The study found that low vitamin D was associated with a fivefold increased risk of developing asthenozoospermia at 95% CI (2.74-8.99). Moreover, there was a positive significant correlation (r=0.285; p<0.001) between serum vitamin D level with total motility and progressive motility (r=0.232; p<0.001). Hence, the study suggests a significant association between asthenozoospermia and low vitamin D levels. However, clinical trials are warranted to further reinforce the findings.
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Astenozoospermia , Infertilidad Masculina , Deficiencia de Vitamina D , Humanos , Masculino , Astenozoospermia/tratamiento farmacológico , Análisis de Semen , Espermatozoides , Motilidad Espermática , Estudios Transversales , Vitaminas , Vitamina D , Deficiencia de Vitamina D/complicacionesRESUMEN
This retrospective study was done in the Obstetrics and Gynaecology Department of Bangladesh Medical College hospital during the period of July 2003 to June 2004 in the women suffering from primary and secondary subfertility, who underwent laparoscopy. The aim of this study was to see the laparoscopic findings of internal genitalia and other pelvic structures in subfertile women. The study group comprises 55 cases of which 67.37% of primary and 32.73% were of secondary subfertility. Both the ovaries were normal looking in 41.81% cases. Endometriosis was present in 5.45% of both the ovaries. Corpus luteum was seen in 20% cases on right ovary and in 27.27% cases on left ovary. Laparoscopy shows normal looking fallopian tube in 65.45% cases in right side and 61.81% cases in the left side. Right sided tubal block was in 5.46% and 9.10 % in the left side. Both the tubes were patent in 81.6% cases.
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Endometriosis/diagnóstico , Enfermedades de las Trompas Uterinas/diagnóstico , Infertilidad Femenina/diagnóstico , Laparoscopía/métodos , Enfermedades del Ovario/diagnóstico , Adulto , Femenino , Humanos , Persona de Mediana Edad , Estudios Retrospectivos , Atención Terciaria de SaludRESUMEN
Vitamin D deficiency (VDD) is common in women with and without polycystic ovary syndrome (PCOS) and may be associated with metabolic and endocrine disorders in PCOS. Aim of the study was to evaluate the association between serum vitamin D level and metabolic syndrome (MS) in PCOS. This cross-sectional study was conducted in PCOS clinic of infertility outpatient department of the department of Reproductive Endocrinology and Infertility at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from July 2018 to June 2019. A total of 170 diagnosed patients with PCOS of aging 20 to 40 years were included in this study. Out of which 85 patients with PCOS MS and rest 85 patients without PCOS MS were considered as Group I and Group II respectively. Serum vitamin D was measured using a chemiluminescent microparticle immunoassay (CMIA). Almost two third (72.9%) populations had vitamin D moderate deficiency (10-20ng/ml) in Group I and 46(54.1%) in Group II. The mean vitamin D was 13.97±4.53ng/ml in Group I 16.02±6.62ng/ml in Group II. There were significant negative correlation found between vitamin D level with weight (r = -0.169; p=0.028), waist circumference (r = -0.208; p=0.007), Waist/Hip ratio (r = -0.205; p=0.007) and diastolic blood pressure (r = -0.187; p=0.014). In binary logistic regression analysis diastolic blood pressure (OR=1.04, 95% CI 0.89-1.29), fasting Glucose (OR=1.09, 95% CI 0.89 - 1.42), HDL (OR=1.11, 95% CI 1.05 - 1.17) and Vitamin D (OR=1.37, 95% CI 1.01 - 1.82) were significant risk factors of metabolic syndrome of the study patients. Vitamin D level was lower in PCOS subjects having MS and higher frequency of body weight, vitamin D deficiency was observed in them compared to the non-MS group. Waist: hip ratio, waist circumference and diastolic blood pressure were the negatively correlated with of vitamin D in the study subjects.
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Síndrome Metabólico , Síndrome del Ovario Poliquístico , Deficiencia de Vitamina D , Femenino , Humanos , Síndrome del Ovario Poliquístico/complicaciones , Síndrome Metabólico/complicaciones , Vitamina D , Estudios Transversales , Bangladesh/epidemiología , Deficiencia de Vitamina D/complicaciones , Vitaminas , Índice de Masa CorporalRESUMEN
The temporal and spectral characteristics of tonic-clonic seizures are investigated using a neural field model of the corticothalamic system in the presence of a temporally varying connection strength between the cerebral cortex and thalamus. Increasing connection strength drives the system into â¼ 10 Hz seizure oscillations once a threshold is passed and a subcritical Hopf bifurcation occurs. In this study, the spectral and temporal characteristics of tonic-clonic seizures are explored as functions of the relevant properties of physiological connection strengths, such as maximum strength, time above threshold, and the ramp rate at which the strength increases or decreases. Analysis shows that the seizure onset time decreases with the maximum connection strength and time above threshold, but increases with the ramp rate. Seizure duration and offset time increase with maximum connection strength, time above threshold, and rate of change. Spectral analysis reveals that the power of nonlinear harmonics and the duration of the oscillations increase as the maximum connection strength and the time above threshold increase. A secondary limit cycle at â¼ 18 Hz, termed a saddle-cycle, is also seen during seizure onset and becomes more prominent and robust with increasing ramp rate. If the time above the threshold is too small, the system does not reach the 10 Hz limit cycle, and only exhibits 18 Hz saddle-cycle oscillations. It is also seen that the time to reach the saturated large amplitude limit-cycle seizure oscillation from both the instability threshold and from the end of the saddle-cycle oscillations is inversely proportional to the square root of the ramp rate.
Asunto(s)
Corteza Cerebral/fisiología , Modelos Neurológicos , Convulsiones/fisiopatología , Tálamo/fisiología , HumanosRESUMEN
In this theoretical work nonlinear behavior of dust ion acoustic solitary waves (SWs) has been investigated, and then the effect of the adiabatic change on them has been observed. The complex plasma system consists of inertial positive and negative ions, Maxwell's electrons, and positively and negatively charged stationary dust particles. The effects of dust polarity on the dust ion acoustic SWs have also been observed. Using the reductive perturbation method, we first derive K-dV equation which lets to analyze both the positive (bright) and negative (dark) solitons in a very limited region. After that mK-dV equation has been derived, and this let to analyze positive soliton for a large region, but cannot show the negative soliton. Finally, the Gardner equation has been derived employing the same method, through which we were able to analyze both the positive and negative solitons for a large region. It has been found that both the positive and negative solitons significantly depend on the mass number density, ion number density, and dust polarity in the adiabatic and isothermal system.
RESUMEN
The incidence of visceral pain among caesarean section can be as high as 50% in sub arachnoid block (SAB) in spite adequate sensory block, which requires conversion to general anesthesia. Different types of adjuvant have been used to augment the effect of local anesthetics but their use is limited due to adverse effects. The effect of intrathecal midazolam along with hyperbaric bupivacaine in sub arachnoid block is less known. So this randomized, double blind study was conducted to evaluate the additive effect of 0.4ml midazolam to 0.5% 3ml bupivacaine on sub arachnoid block in scheduled elective caesarean section. This study demonstrated that the addition of intrathecal 0.4ml midazolam to spinal 0.5% bupivacaine kept all the characteristics of block unaffected, furthermore pain score VAS 3.4±1.3 in Group A and 1.8±1.22 in Group B which is statistically significant, the requirement of intraoperative analgesia and also increased the duration of postoperative analgesia that is 130.3±5.4 minute in Group A, 265.1±3.6 minute in Group B and also statistically significant. Therefore addition of 2.0mg midazolam with 0.5% bupivacaine significantly reduces the VAS score, reduces the intraoperative visceral pain and need of analgesia.
Asunto(s)
Anestesia Raquidea , Anestésicos Locales , Midazolam , Dolor Postoperatorio , Anestésicos Locales/uso terapéutico , Bupivacaína , Cesárea , Método Doble Ciego , Femenino , Humanos , Inyecciones Espinales , Midazolam/uso terapéutico , Dolor Postoperatorio/tratamiento farmacológico , Dolor Postoperatorio/prevención & control , Embarazo , Estudios ProspectivosRESUMEN
The dynamics of interictal events between absence seizures and their relationship to seizures themselves are investigated by employing a neural field model of the corticothalamic system. Interictal events are modeled as being due to transient parameter excursions beyond the seizure threshold, in the present case by sufficiently temporally varying the connection strength between the cerebral cortex and the thalamus. Increasing connection strength drives the system into â¼3-Hz seizure oscillations via a supercritical Hopf bifurcation once the linear instability threshold is passed. Depending on the time course of the excursion above threshold, different interictal activity event dynamics are seen in the time series of corticothalamic fields. These resemble experimental interictal time series observed via electroencephalography. It is found that the morphology of these events depends on the magnitude and duration of the excursion above threshold. For a large-amplitude excursion of short duration, events resemble interictal spikes, where one large spike is seen, followed by small damped oscillations. For a short excursion with long duration, events like observed interictal periodic sharp waves are seen. When both amplitude and duration above threshold are large, seizure oscillations are seen. Using these outcomes, proximity to seizure can be estimated and tracked.
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Modelos Neurológicos , Convulsiones/patología , Convulsiones/fisiopatología , Encéfalo/patología , Encéfalo/fisiopatología , Electroencefalografía , Neuronas/patologíaRESUMEN
This prospective observational study was carried out in the Infertility Unit, Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from February 2011 to December 2013. Sixty-nine (69) subfertile women who were seropositive for Chlamydia Trachomatis were included in this study. Inclusion criteria was patients with sub-fertility having age between 22 and 40 years, seeking infertility treatment, normal ovarian function, all normozoospermic male partner, duration of infertility ranged from 1.5 to 14 years. Exclusion criteria were patients having sub-fertility with extensive pelvic and/or ovarian surgery, endometriosis, ablation of endometriotic spots, pelvic tuberculosis and history of ectopic pregnancy. Before laparoscopic evaluation, all study women were screened for Chlamydia Trachomatis Specific IgG & IgM antibodies using ELISA in the Microbiology Department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. All the study women had positive results for IgG antibodies. All study women underwent diagnostic laparoscopy. During laparoscopy, we observed the condition of pelvic cavity, uterus, fallopian tubes, ovaries, peritubal adhesions, tubo-ovarian relationship, status of Pouch of Douglas (POD), fimbriae etc. During dye test procedure, dilute methylene blue dye was injected through the cervical canal and the dye spill out was observed to confirm the tubal patency or blockage or pattern of flow of dye. The results of laparoscopic findings demonstrated that mobility of uterus was restricted in 20(29%) cases, adhesion of uterus with peritoneum was in 8(11.6%) cases, uterine fibroid was present in 11(15.9%) cases, hydrosalpinx in right fallopian tubes were in 27(39.1%) cases, in left fallopian tubes were in 32(46.4%) cases and in both fallopian tubes in 16(23.2%) cases, inflamed right fallopian tubes in 32(46.4%) cases, inflamed left fallopian tubes in 36(52.2%) cases and inflamed both fallopian tubes in 26(37.7%) cases, adhesions in pouch of Douglas was in 4(5.8%) cases, collections in pouch of Douglas was in 7(10.1%) cases and obliterations in pouch of Douglas was in 5(7.2%) cases. Results of Dye test during laparoscopy were that right fallopian tube was blocked in 32(46.4%) cases, left fallopian tube was blocked in 32(46.4%) cases and both fallopian tubes were blocked in 21(30.4%) cases. This study shows that by laparoscopy, significant number of cases of tubal and pelvic pathology was diagnosed in the chlamydia trachomatis seropositive subfertile female. This indicates strong correlation between seropositivity of chlamydia trachomatis and/or pelvic pathology detected by diagnostic laparoscopy.
Asunto(s)
Infecciones por Chlamydia , Enfermedades de las Trompas Uterinas , Infertilidad Femenina , Enfermedades Uterinas , Adulto , Bangladesh , Infecciones por Chlamydia/complicaciones , Chlamydia trachomatis , Enfermedades de las Trompas Uterinas/microbiología , Femenino , Humanos , Laparoscopía , Embarazo , Estudios Prospectivos , Enfermedades Uterinas/microbiología , Adulto JovenRESUMEN
The transport of various metabolically important substances along the endocytic and secretory pathways involves budding as well as fusion of vesicles with various intracellular compartments and plasma membrane. The membrane-membrane fusion events between various sub-compartments of the cell are believed to be mainly mediated by so-called "fusion proteins". This study shows that beside the proteins, lipid components of membrane may play an equally important role in fusion and budding processes. Inside out (ISO) as well as right side out (RSO) erythrocyte vesicles were evaluated for their fusogenic potential using conventional membrane fusion assay methods. Both fluorescence dequenching as well as content mixing assays revealed fusogenic potential of the erythrocyte vesicles. Among two types of vesicles, ISO were found to be more fusogenic as compared to the RSO vesicles. Interestingly, ISO retained nearly half of their fusogenic properties after removal of the proteins, suggesting the remarkable role of lipids in the fusion process. In another set of experiments, fusogenic properties of the liposomes (subtilosome), prepared from phospholipids isolated from Bacillus subtilis (a lower microbe) were compared with those of erythrocyte vesicles. We have also demonstrated that various types of vesicles upon interaction with macrophages deliver encapsulated materials to the cytosol of the cells. Membrane-membrane fusion was also followed by the study, in which a protein synthesis inhibitor ricin A (that does not cross plasma membrane), when encapsulated in the erythrocyte vesicles or subtilosomes was demonstrated to gain access to the cytosol.
Asunto(s)
Liposomas/metabolismo , Fusión de Membrana/fisiología , Ovalbúmina/metabolismo , Fosfolípidos/metabolismo , Células Presentadoras de Antígenos/metabolismo , Linfocitos T CD8-positivos/metabolismo , Eritrocitos/metabolismo , Humanos , Immunoblotting , Macrófagos/efectos de los fármacos , Macrófagos/metabolismo , Péptido Hidrolasas/metabolismo , Biosíntesis de Proteínas/efectos de los fármacos , Ricina/farmacología , Factores de TiempoRESUMEN
Earlier we have demonstrated that novel fusogenic liposomes made up of lipid from Escherichia coli (escheriosomes) have strong tendency to fuse with the plasma membrane of target cells and thereby delivering the entrapped contents into their cytosol. The delivery of entrapped antigen in cytosol of the target cells ensues its processing and presentation along with MHC class I pathway that eventually elicit antigen specific cytotoxic T cells. The result of the present study revealed that immunization of BALB/c mice with escheriosome-encapsulated Salmonella typhimurium (S. typhimurium) cytosolic antigens resulted in the augmentation of antigen specific cytotoxic T cell lymphocyte as well as IgG responses. In contrast, free or conventional liposome (PC liposome) encapsulated antigen failed to induce CD8+ CTLs in the immunized animals. Further, immunization with escheriosome-encapsulated antigen resulted in significant enhancement in the release of IFN-gamma and IgG2a in the experimental animals. Interestingly, the immunization with escheriosome-encapsulated antigen resulted in upregulation of CD80 and CD86 on the surface of antigen presenting cells (APCs) as well. Finally, the results of the present study reveal that immunization of animals with escheriosomes encapsulated antigen protected them against virulent S. typhimurium infection. This was evident by increased survival, and reduced bacterial burden in vital organs of the immunized animals. The data of the present study suggest that escheriosomes can emerge as an effective vehicle for intracellular delivery of antigen and thus hold promise in development of liposome based vaccine against Salmonella and other intracellular pathogens.