Assessment of radioactivity level and associated radiological hazard in fertilizer from Dhaka.

Miners, factory workers, traders, end-users, and foodstuff consumers all run the risk of encountering health hazards derived from the presence of elevated levels of radiation in fertilizers, as these groups often come into direct or indirect contact with fertilizers as well as raw materials throughout various linked processes such as mineral extractions, fertilizer production, agricultural practices. A total of 30 samples of various kinds of fertilizer produced in different factories in Dhaka megacity were analyzed to quantify the concentrations of primordial radionuclides using HPGe detector. Among the analyzed samples, average (range) concentration of 40K was found to be 9920 ± 1091 (8700 ± 957-11,500 ± 1265), 9100 ± 1001 (8600 ± 946-9600 ± 1056), 2565 ± 282 (2540 ± 279-2590 ± 285), and 3560 ± 392 (2620 ± 288-4500 ± 495) Bq/kg in the samples of Muriate of Potash Fertilizer, Sulphate of Potash Fertilizer, Humic Acid Fertilizer, and NPKS Fertilizer, respectively. Elevated concentration of 226Ra was found in Triple Super Phosphate Fertilizer with a mean (range) of 335 ± 37 (290 ± 32-380 ± 42) Bq/kg. The higher activity of 40K can be linked to the greater levels of elemental potassium in phosphate fertilizer. Elevated concentrations of radionuclides may also result from variations in chemical processes as well as the local geology of the mining areas where the raw materials were extracted for fertilizer production. Numerous fertilizer brands surpass prescribed limits for various hazardous parameters, presenting significant health risks to factory workers, farmers, and consumers of agricultural products. This study provides baseline information on the radioactivity of fertilizers, which could be used to develop mitigation methods, establish national fertilizer usage limits, justify regulatory frameworks, and raise public awareness of fertilizer overuse. The findings of the study could potentially help to explore the impact of fertilizer on the food chain.

Factors Influencing the Formation of Nitrous Acid from Photolysis of Particulate Nitrate.

Enhanced photolysis of particulate nitrate (pNO3) to form photolabile species, such as gas-phase nitrous acid (HONO), has been proposed as a potential mechanism to recycle nitrogen oxides (NOx) in the remote boundary layer ("renoxification"). This article presents a series of laboratory experiments aimed at investigating the parameters that control the photolysis of pNO3 and the efficiency of HONO production. Filters on which artificial or ambient particles had been sampled were exposed to the light of a solar simulator, and the formation of HONO was monitored under controlled laboratory conditions. The results indicate that the photolysis of pNO3 is enhanced, compared to the photolysis of gas-phase HNO3, at low pNO3 levels, with the enhancement factor reducing at higher pNO3 levels. The presence of cations (Na+) and halides (Cl-) and photosensitive organic compounds (imidazole) also enhance pNO3 photolysis, but other organic compounds such as oxalate and succinic acid have the opposite effect. The precise role of humidity in pNO3 photolysis remains unclear. While the efficiency of photolysis is enhanced in deliquescent particles compared to dry particles, some of the experimental results suggest that this may not be the case for supersaturated particles. These experiments suggest that both the composition and the humidity of particles control the enhancement of particulate nitrate photolysis, potentially explaining the variability in results among previous laboratory and field studies. HONO observations in the remote marine boundary layer can be explained by a simple box-model that includes the photolysis of pNO3, in line with the results presented here, although more experimental work is needed in order to derive a comprehensive parametrization of this process.

Evaluation of accessibility and equity to hospitals by public transport: evidence from six largest cities of Ohio.

INTRODUCTION: In the United States, health care has long been viewed as a 'right,' and residents of the state of Ohio are no exception. The Ohio Department of Health ensures that this right exists for all residents of Ohio. Socio-spatial characteristics, however, can have an impact on access to health care, particularly among vulnerable groups. This article seeks to measure the spatial accessibility to healthcare services by public transport in the six largest cities of Ohio based on population and to compare the accessibility of healthcare to vulnerable demographic groups. To the authors' knowledge, this is the first study to analyze the accessibility and equity of hospitals by public transit across different cities in Ohio, allowing the identification of common patterns, difficulties, and knowledge gaps. METHODOLOGY: Using a two-step floating catchment area technique, the spatial accessibility to general medical and surgical hospitals through public transportation was estimated, considering both service-to-population ratios and travel time to these health services. The average accessibility of all census tracts and the average accessibility of the 20% of most susceptible census tracts were determined for each city. Using Spearman's rank correlation coefficient between accessibility and vulnerability, an indicator was then devised to evaluate vertical equity. FINDINGS: Within cities (except Cleveland), people of vulnerable census tracts have less access to hospitals via public transportation. These cities (Columbus, Cincinnati, Toledo, Akron, and Dayton) fail in terms of vertical equity and average accessibility. According to this, vulnerable census tracts in these cities have the lowest accessibility levels. CONCLUSION: This study emphasizes the issues connected with the suburbanization of poverty in Ohio's large cities and the need to provide adequate public transportation to reach hospitals on the periphery. In addition, this study shed light on the need for additional empirical research to inform the implementation of guidelines for healthcare accessibility in Ohio. Researchers, planners, and policymakers who want to make healthcare more accessible for everyone should take note of the findings in this study.

Evaluation of transfer factors of 226Ra, 232Th, and 40K radionuclides from soil to grass and mango in the northern region of Bangladesh.

Bangladesh is a rapidly developing country, which is vulnerable to various types of pollution due to the large-scale industrial and associated human activities that might potentially affect the locally harvested foodstuffs. Therefore, the transfer factor is an essential tool to assess the safety of foodstuffs due to the presence of natural radioactivity in environmental matrix and/or strata. This is a first study of its kind conducted in a well-known region for mango farming in Bangladesh, measuring the uptake of naturally occurring radioactive materials (NORMs) by grass and mango from soil to assess the ingestion doses to humans. The HPGe gamma-ray detector was used to determine the concentrations of NORMs in samples of soil (20), grass (10), and mango (10), which were then used to calculate the transfer factors of soil to grass and soil to mango. Average activity concentrations of 226Ra, 232Th, and 40K in associated soil samples (47.27 ± 4.10, 64.49 ± 4.32, 421.60 ± 28.85) of mango and 226Ra and 232Th in associated soil samples (45.07 ± 3.93, 52.17 ± 3.95) of grass were found to exceed the world average values. The average transfer factors (TFs) for mango were obtained in the order of 40K(0.80) > 226Ra (0.61) > 232Th (0.31), and for grass, it shows the order of 40K (0.78) > 232Th (0.64) > 226Ra (0.56). However, a few values (3 mango samples and 3 grass samples) of the estimated TFs exceeded the recommended limits. Moreover, Bangladesh lacks the transfer factors for most of the food crops; therefore, calculation of TFs in the major agricultural products is required all over Bangladesh, especially the foodstuffs produced near the Rooppur Nuclear Power Plant, which is scheduled to be commissioned in 2023.

Vertical distributions of radionuclides along the tourist-attractive Marayon Tong Hill in the Bandarban district of Bangladesh.

This is the first attempt in the world to depict the vertical distribution of radionuclides in the soil samples along several heights (900 feet, 1550 feet, and 1650 feet) of Marayon Tong hill in the Chittagong Hill Tracts, Bandarban by HPGe gamma-ray spectrometry. The average activity concentrations of 232Th, 226Ra, and 40K were found to be 37.15 ± 3.76 Bqkg-1, 19.69 ± 2.15 Bqkg-1, and 347.82 ± 24.50 Bqkg-1, respectively, where in most cases, 232Th exceeded the world average value of 30 Bqkg-1. According to soil characterization, soils ranged from slightly acidic to moderately acidic, with low soluble salts. The radium equivalent activity, outdoor and indoor absorbed dose rate, external and internal hazard indices, external and internal effective dose rates, gamma level index, and excess lifetime cancer risk were evaluated and found to be below the recommended or world average values; but a measurable activity of 137Cs was found at soils collected from ground level and at an altitude of 1550 feet, which possibly arises from the nuclear fallout. The evaluation of cumulative radiation doses to the inhabitants via periodic measurement is recommended due to the elevated levels of 232Th.This pioneering work in mapping the vertical distribution of naturally occurring radioactive materials (NORMs) can be an essential factual baseline data for the scientific community that may be used to evaluate the variation in NORMs in the future, especially after the commissioning of the Rooppur Nuclear Power Plant in Bangladesh in 2024.

Evaluation of radioactivity in soil and rock samples from an undiscovered sea beach in the southeastern coastline of Bangladesh and associated health risk.

This study marks the first-ever assessment of radiological hazards linked to the sands and rocks of Patuartek Sea Beach, situated along one of the world's longest sea beaches in Cox' Bazar of Bangladesh. Through the utilization of an HPGe detector, a comprehensive analysis of the activity concentrations of 226Ra, 232Th, and 40 K was conducted, and their activity ranged from 7 to 23 Bq/kg, 9-58 Bq/kg, and 172-340 Bq/kg, respectively, in soils, and 19-24 Bq/kg, 27-39 Bq/kg, and 340-410 Bq/kg, respectively, in rocks. Some sand samples exhibited elevated levels of 232Th, while the rock samples displayed higher levels of 40 K compared to the global average. The radiological hazard parameters were assessed, and no values surpassed the recommended limits set by several international organizations. Hence, the sands and rocks of Patuartek sea beach pose no significant radiological risk to the residents or tourists. The findings of this study provide crucial insights for the development of a radiological baseline map in the country, which is important due to the commissioning of the country's first nuclear power plant Rooppur Nuclear Power Plant. The data may also stimulate interest in the rare-earth minerals present in the area, which is important for the electronics industry, thorium-based nuclear fuel cycles.

Non-fumigant Nematicides are Promising Alternatives to Fumigants for the Management of Meloidogyne Enterolobii in Tobacco.

Experiments were conducted to evaluate the efficacy of three currently available non-fumigant chemical nematicides (oxamyl, fluopyram, and fluensulfone) and a biological nematicide derived from Burkholderia against Meloidogyne enterolobii on tobacco in a growth room environment. The non-fumigant chemical nematicides greatly suppressed nematode egg production compared to the untreated control, the suppression being 99.9% for fluensulfone and oxamyl, and 93% for fluopyram. Similarly, oxamyl-, fluensulfone-, and fluopyram-treated pots, respectively, had 99%, 98%, and 94% less J2/100 cm3 of soil than those in the control. The biological nematicide did not have a significant effect on nematode egg production and the soil abundance of J2. The root biomass of tobacco was significantly reduced by the application of fluensulfone, while the effects of oxamyl, fluopyram, and Burkholderia metabolites were not significant compared to the untreated control. Results from this study suggest that non-fumigant nematicides have a potential to serve as an alternative to fumigant nematicides.

Real-world effectiveness of adalimumab in patients with moderate-to-severe hidradenitis suppurativa: the 1-year SOLACE study.

BACKGROUND: Long-term, real-word data are needed to help manage patients with hidradenitis suppurativa (HS) through this recurrent, painful and debilitating disease. OBJECTIVES: To primarily measure real-world effectiveness of adalimumab in HS and to secondarily observe clinical course of HS in the light of patients' response. METHODS: In SOLACE, adults with moderate-to-severe HS in need for change in ongoing therapy were treated with adalimumab for up to 52 weeks as per physician's medical practice. Treatment effectiveness was measured by Hidradenitis Suppurativa Clinical Response (HiSCR). Inflammatory nodules, abscesses and draining fistulas were counted, Hurley stage was assessed, and disease severity was rated using the International HS Severity Scoring System (IHS4). A post hoc analysis further explored the HiSCR response by abscess and inflammatory nodule (AN) count at baseline (low, medium and high) and gender. Spontaneously reported safety events were collected. RESULTS: From 23 Canadian centres, 69% of the 138 patients achieved HiSCR at week 24, which increased to 82% and 75% at week 52 in patients with medium and high AN counts, respectively. Gender (4 times the odds for female) and age at HS onset (5% decrease with each additional year) had an effect on achieving HiSCR. Treatment with adalimumab led to an important decrease in number of lesions in responders, with most gains observed in inflammatory nodules, more frequently in the lower body area of patients in the high AN count group. The IHS4 scores of responders were substantially lowered, with a larger decrease in patients of the high AN count group. No new safety signal was detected. CONCLUSIONS: The effectiveness of adalimumab was maintained during this 1-year period, and an optimal gain was documented for patients with medium and high AN counts. These real-world data support a prompt treatment of HS patients and the use of IHS4 to monitor treatment.

Ergodic Capacity Analysis of Full Duplex Relaying in the Presence of Co-Channel Interference in V2V Communications.

We analyze the ergodic capacity of a dual-hop full duplex amplify-and-forward (AF) vehicle-to-vehicle (V2V) cooperative relaying system over Nakagami-m fading channels. In this context, the impacts of self-interference (SI) at the relay and co-channel interference (CCI) at the destination are taken into account in this analysis. Precisely, based on the analysis of the moment generating function (MGF) of the signal-to-interference-plus-noise ratio (SINR), new exact and lower bound expressions for the ergodic capacity are derived. The ergodic capacity upper bound is also derived based on the asymptotic outage probability of the approximated SINR. Monte-Carlo simulation results are presented to corroborate the derived analytical results. Our results show the significant impact of the considered interferences on the system performance. It is shown that the ergodic capacity is degraded when the average SI at the relay and/or the average CCI at the destination is increased. This highlights the importance of taking these phenomena into account in the performance evaluation in order to assess the practical limit of full duplex relaying (FDR) cooperative wireless communications. Interestingly, it is also observed that FDR with SI and CCI still shows a higher ergodic capacity than the interference-free half duplex relaying, especially at medium to high signal-to-noise ratios (SNRs).

Demonstration of a 120° hybrid based simplified coherent receiver on SOI for high speed PON applications.

We demonstrate the first simplified coherent receiver using a 120° hybrid on silicon-on-insulator (SOI) for high speed PON applications. This coherent receiver integrates an inverse taper edge coupler for the received signal, a vertical grating coupler for the local oscillator input, a polarization splitter and rotator (PSR), a 120° hybrid based on a 3×3 multimode interference (MMI) coupler, and three germanium photodetectors. We achieved 25 Gbit/s two-level pulse amplitude modulation (PAM-2) transmission over 30 km standard single mode fiber (SMF) in the C-band without any digital signal processing (DSP) (e.g., pre-emphasis, pulse shaping, equalization, nonlinearity compensation) and dispersion compensation (e.g., optical or digital) either at the transmitter or at the receiver. The requirements for frequency and phase locking of the local oscillator (LO) were avoided due to the use of intensity modulated signals. Receiver sensitivities of -23.70 dBm, -20.30 dBm, and -15.10 dBm are achieved at a bit error rate (BER) below the hard-decision forward error correction (HD-FEC) threshold (i.e., 3.8 × 10-3) in back-to-back (B2B), after 21 km and 30 km, respectively. We also demonstrate 25 Gbit/s PAM-4 transmission achieving receiver sensitivities of -15.30 dBm, -13.90 dBm, and -9.50 dBm below the HD-FEC threshold in B2B, after 10.5 km and 21 km, respectively.

First Evidence for cos2ß>0 and Resolution of the Cabibbo-Kobayashi-Maskawa Quark-Mixing Unitarity Triangle Ambiguity.

We present first evidence that the cosine of the CP-violating weak phase 2ß is positive, and hence exclude trigonometric multifold solutions of the Cabibbo-Kobayashi-Maskawa (CKM) Unitarity Triangle using a time-dependent Dalitz plot analysis of B^{0}→D^{(*)}h^{0} with D→K_{S}^{0}π^{+}π^{-} decays, where h^{0}∈{π^{0},η,ω} denotes a light unflavored and neutral hadron. The measurement is performed combining the final data sets of the BABAR and Belle experiments collected at the ϒ(4S) resonance at the asymmetric-energy B factories PEP-II at SLAC and KEKB at KEK, respectively. The data samples contain (471±3)×10^{6}BB[over ¯] pairs recorded by the BABAR detector and (772±11)×10^{6}BB[over ¯] pairs recorded by the Belle detector. The results of the measurement are sin2ß=0.80±0.14(stat)±0.06(syst)±0.03(model) and cos2ß=0.91±0.22(stat)±0.09(syst)±0.07(model). The result for the direct measurement of the angle ß of the CKM Unitarity Triangle is ß=[22.5±4.4(stat)±1.2(syst)±0.6(model)]°. The measurement assumes no direct CP violation in B^{0}→D^{(*)}h^{0} decays. The quoted model uncertainties are due to the composition of the D^{0}→K_{S}^{0}π^{+}π^{-} decay amplitude model, which is newly established by performing a Dalitz plot amplitude analysis using a high-statistics e^{+}e^{-}→cc[over ¯] data sample. CP violation is observed in B^{0}→D^{(*)}h^{0} decays at the level of 5.1 standard deviations. The significance for cos2ß>0 is 3.7 standard deviations. The trigonometric multifold solution π/2-ß=(68.1±0.7)° is excluded at the level of 7.3 standard deviations. The measurement resolves an ambiguity in the determination of the apex of the CKM Unitarity Triangle.

Influence of green grass-based diets on growth and reproductive performance in dairy heifers.

The objective of this study was to monitor the changes in growth, dry matter intake, and blood profiles (nutrition and reproductive hormones) of dairy heifers in response to green grass-based diets. Twelve crossbred heifers were equally divided into group 1: rice straw and concentrate; group 2: rice straw, green grass, and concentrate; group 3: green grass and concentrate; group 4: green grass, soybean hay, and concentrate. Dry matter intake in group 4 was found 6% higher (P < 0.05) than group 1. Negative body weight gain was found in group 1 and group 2 showed 14% higher body weight gain per 30 days compared to groups 3 and 4 (P < 0.05). Heifers in group 4 had significantly (P < 0.05) higher heart girth gain, serum albumin, urea, and blood urea nitrogen than the heifers in other groups. Endocrine parameters were found similar among groups. Overall, supply of green grass especially a mix of leguminous and non-leguminous was found advantageous in heifer feeding.

Effect of calcium and salicylic acid on quality retention in relation to antioxidative enzymes in radish stored under refrigerated conditions.

Effect of post harvest treatments with calcium chloride (CaCl2) and salicylic acid (SA) on physiological and biochemical parameters in relation to activities of antioxidative enzymes were investigated in radish. Radish of variety Punjab Safed Mooli 2 was harvested, washed and treated with CaCl2 (1, 1.5 and 2%) or SA (1, 1.5 and 2 mM). Treated as well as untreated radish were placed in open trays and stored under refrigerated (5 ± 1 °C, 90% RH) conditions for 42 days. Treatment of radish with CaCl2 and SA slowed down changes in physiological weight, colour, total soluble solids, ascorbic acid, titrable acidity, total phenolics and antioxidant activity. Treated samples exhibited higher enhancement in activities of antioxidant enzymes viz. catalase (CAT), superoxide dismutase (SOD), glutathione reductase (GR), peroxidase (POD), dehydroascorbate reductase (DHAR) and monodehydro-ascorbate reductase (MDHAR) than untreated samples. However SA was found to be more effective in slowing down the metabolic activities of radish as compared to CaCl2 treatment. Among all the treatments, 1.5 mM SA maintained the quality parameters to greater extent probably by reducing the oxidative stress to larger extent due to highest activities of antioxidative enzymes and can be used to enhance the shelf life of radish during refrigerated storage.

Impact of Adrenocortical Insufficiency on Biochemical Parameters in Haemodynamically Stable Cirrhotic Patients with Ascites.

Cirrhosis has many complications regardless of the aetiology. Among them, adrenal insufficiency is recently identified entity. A prospective cohort study was done to evaluate the biochemical impact of adrenocortical insufficiency in haemodynamically stable, non-septic, cirrhotic patients with ascites and had been performed at the inpatient of GHPD department, BIRDEM, Dhaka from April 2011 to March 2012. A total of fifty three (53) patients fulfilling inclusion criteria were included in the study. Patients were divided into two groups: Group A (patients of normal adrenal function) and Group B (patients of insufficient adrenal function) and those were followed up for the next 6 months. In Group A, the total number of patients was 25(47%) and in Group B it was 28(53%). Between two groups, mean age difference and gender difference were not statistically significant. (p value was 0.278 and 0.933, respectively). At enrollment, there was significant lower mean Hb concentration in Group B (p=0.008). There was no significant difference of means of WBC count and platelet count between two groups (p value was 0.829 and 0.333, respectively). There were significant abnormalities in serum bilirubin, serum albumin, INR, SBP, HRS, Serum Na concentration, TCO2 concentration in Group B patients at follow up after 6 months. Adrenal insufficient decompensated cirrhotic patients have higher biochemical abnormalities, thus higher morbidities.

Impact of Adrenocortical Insufficiency on Clinical Parameters in Haemodynamically Stable Cirrhotic Patients with Ascites.

Cirrhosis has many complications regardless of the aetiology. Complications include splenomegaly, ascites, hepatic encephalopathy, spontaneous bacterial peritonitis, hepatorenal syndrome and hepatocellular carcinoma and also linked to abnormalities in the endocrine system, including abnormal sex hormone metabolism, thyroid disease, osteoporosis, and, most recently identified, adrenal insufficiency. This prospective cohort study was done to evaluate the impact of adrenocortical insufficiency on clinical parameters in haemodynamically stable cirrhotic patients with ascites and had been performed at the inpatient of GHPD Department, BIRDEM, Dhaka, Bangladesh from April 2011 to March 2012. A total of fifty three (53) patients fulfilling inclusion criteria were included in the study. Patients were divided into two groups: Group A (patients of normal adrenal function) and Group B (patients of insufficient adrenal function) and those were followed up for the next 6 months. In Group A, the total number of patients was 25(47%) and in Group B it was 28(53%). Between two groups, mean age difference and gender difference were not statistically significant (p value was 0.278 and 0.933, respectively). Group B patients had significant higher CLD duration (p=0.004). Haematemesis and/or maelena was significantly lower in Group B at follow up (p=0.0001) due to significant higher number of band ligation in this group (p=0.009). Hepatic encephalopathy was significantly higher in Group B at enrollment (p=0.028) and at follow up (p<0.001). During the period of follow up, significant higher number of patients had developed hepatic encephalopathy in Group B compared to Group A (p<0.05). There was statistically significant higher number of patients had SBP (p=0.031) in Group B at follow up. During the period of follow up, only 1(4%) patient in Group A and 5(18%) patients in Group B died. There was no significant difference of number of death between two groups (p=0.196). Adrenal insufficient decompensated cirrhotic patients have higher morbidities.

Extrusion and Extruded Products: Changes in Quality Attributes as Affected by Extrusion Process Parameters: A Review.

Extrusion of foods is an emerging technology for the food industries to process and market a large number of products of varying size, shape, texture, and taste. Extrusion cooking technology has led to production of wide variety of products like pasta, breakfast cereals, bread crumbs, biscuits, crackers, croutons, baby foods, snack foods, confectionery items, chewing gum, texturized vegetable protein (TVP), modified starch, pet foods, dried soups, dry beverage mixes etc. The functional properties of extruded foods plays an important role for their acceptability which include water absorption, water solubility, oil absorption indexes, expansion index, bulk density and viscosity of the dough. The aim of this review is to give the detailed outlines about the potential of extrusion technology in development of different types of products and the role of extrusion-operating conditions and their effect on product development resulting in quality changes i.e physical, chemical, and nutritional, experienced during the extrusion process.

Does Education Have Any Influence on Symptom Score of IBS Patients: A Randomized Controlled Study.

Despite much research, the pathophysiology of IBS remains poorly understood. So it is very difficult to treat. There is no standard treatment for IBS. Because IBS symptoms can be elicited or exacerbated by diet and stress, this suggests that patient education regarding his or her illness might be beneficial to patients in managing their symptoms. This study was done to see the short term effects of outpatient education in relation to change of symptom score in IBS patients. This is a prospective randomized comparative study. In this study a total of 80 patients were included. Forty patients were given only pharmacological management with Mebevarine hydrochloride 135mg thrice daily half an hour before meal and Amitryptline 10mg at night for six months and another forty were given education in addition to the same pharmacological treatment. In both the study group [medical management only versus medical management with education] changes of symptoms and quality of life of patients of IBS were assessed by using previously used, specially designed symptoms scoring system and a validated IBS-QOL instrument. There was no significant difference in severity of symptoms between only drug treatment group (118.973) and education plus drug treatment group (119.57) before treatment. The difference of improvement between the education group and without education group was not statistically significant (P>0.05), though the subsidence of pain in both the group before and after treatment was statistically significant (P<0.01).

Comparative Study between Pentoxifylline and Pioglitazone in the Treatment of Non-Alcoholic Fatty Liver Disease among Newly Detected Glucose Intolerant Patients.

This quasi experimental study was carried out to compare the efficacy of Pentoxifylline versus Pioglitazone in non-alcoholic fatty liver disease (NAFLD) among newly detected glucose intolerant patients attended at GHPD, BIRDEM, Dhaka, Bangladesh from March 2011 to May 2012. Sixty patients with newly detected abnormal glucose tolerance, naive to any antidiabetic drugs were randomly selected, with the findings of USG changes of fatty liver and raised ALT. Patients were divided into Group A (51.7%; mean age - 44.45±7.34 years, BMI - 26.76±3.65kg/m(2)) receiving Pioglitazone 30mg/day and Group B (48.3%; mean age - 43.97±10.13 years, BMI - 27.52±4.44kg/m(2)) receiving Pentoxifylline 1200mg/day along with dietary and lifestyle modification. Baseline, follow up 1 & follow up 2: Serum AST in Group A (66.58±40.78U/L, 45.00±19.43U/L and 33.25±9.92U/L) respectively and in Group B (54.13±20.11U/L, 38.31±12.90U/L and 30.62±9.63U/L) respectively. Serum ALT in Group A (113.48±61.38U/L, 61.16±19.45U/L and 42.45±13.84U/L) respectively & in Group B (99.13±37.95U/L, 50.27±15.95U/L and 37.24±9.51U/L) respectively. No patient with normal USG finding was included in the study. Baseline USG finding: Grade I - Group A (35.5%), Group B (27.6%); Grade II - Group A (54.8%), Group B (48.3%); Grade III - Group A (9.7%), Group B (24.1%). Final Follow up: Normal - Group A (16.1%), Group B (10.3%); Grade I - Group A (38.7%), Group B (34.5%); Grade II - Group A (41.9%), Group B (44.8%); Grade III - Group A (3.2%), Group B (10.3%). Within groups findings were statistically significant (P<0.001) but between groups not significant (P>0.001). Biochemical and USG grading were improved in follow ups in both the groups. Such findings were observed due to synergistic effect of both therapeutic intervention along with supplementary dietary and lifestyle modification. Both Pioglitazone and Pentoxifylline have similar therapeutic outcome combined with supplementary dietary and lifestyle modification.

Assessing the Rehabilitation of Achilles Tendon Ruptures using Modified Teuffer and Lindholm Technique.

The aim of this study is to assess the optimum rehabilitation and the functional outcome of open repaired Achilles tendon ruptures. This study was conducted for the 18 consecutive patients of complete ruptures at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from 2012 to 2013. Two groups were considered during 6 to 18 months post-operative observation and each group consist 9 patients. In the Group I, modified Teuffer's and in Group II, Lindholm operative methods were employed for the open repair of Achille tendon. The post operative outcomes were assessed for both of the groups through the modified Thermann's scores. In this study the patients median age was seen 39 years with 72.2% male and 27.8% female. The Thompson test was found positive in pre-operative and negative in post-operative outcome. The results shown that Achilles tendon ruptures occurred in 4 to 6cm rupture site, where the rupture side was 61.1% left and 38.9% right. The subjective overall assessment of total Thermann's scores were found very good (91 to 96) in 4 cases and (90 to 98) in 3 cases for Group I and Group II, respectively. Both of the operative techniques were found accountable results for rehabilitation. Therefore, based on the further statistical evidence of higher correlations and errors it may be concluded that Achilles tendon ruptures can be treated by modified Teuffer's or Lindholm technique.