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

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

Correlation between grades of intraventricular hemorrhage and severity of hypoxic ischemic encephalopathy in perinatal asphyxia.

This study was done to find out the correlation between various grades of Intraventricular Hemorrhage (IVH) and stages of HIE in perinatal asphyxia and to determine the short-term outcome of the affected baby. This observational study was conducted in Neonatal ward of Dhaka Shishu Hospital (DHS) and Dhaka Medical College Hospital for period of 37 months from January 2004 to January 2007. Total 189 perinatally asphyxiated babies were enrolled for HIE staging and cranial Ultrasonogram (USG) to find out grades of IVH. Finally 178 newborns were fulfilling all the necessary criteria for statistical analysis of the collected data on prescribed questionnaire. Among 178 perinatally asphyxiated newborns HIE stages - I, II, III were 50(28%), 10(56%) and 28(16%) respectively. Out of this 178 neonates total 50(28%) developed various grades IVH. Grades of IVH, I, II, III, IV were 15(30%), 18(36%), 10(20%) and 7(14%) respectively. There was significant correlation between the severity of HIE staging and grades of IVH. Short term outcome was poor in HIE-III, IVH grade III and IV. There is a direct relationship between different grades of IVH and stages of HIE. That is more the severe stages of HIE there is more chances to develop severe grades of IVH, Immediate morbidity and mortality is dependent on the grades of IVH and severity of stages of HIE.

Comparison between azithromycin and cefixime in the treatment of typhoid fever in children.

An intervention study was carried out in the department of paediatrics of Mymensingh Medical College Hospital, Mymensingh to compare the clinical efficacy of Azithromycin in the treatment of childhood typhoid fever with that of cefixime for a period of one year from January 2011 to December 2011. A total of 60 cases of typhoid fever were enrolled in to a randomized clinical trial and was divided into two groups. The inclusion criteria of the cases were: Documented fever for more than 4 days plus two or more of the following clinical features: toxic physical appearance, intestinal complaints, coated tongue, ceacal gurgling, hepatomegaly and splenomegaly, diarrhoea and constipation plus positive Widal test and/or blood culture positivity. Patients who had complication like GIT heamorrhage; intestinal perforaion and/or shock were excluded from the study. Data were collected in a structured questionnaire. Azithromycin was given at a dose of 10mg/kg/day for a period of 07 days Cefixime was given at a dose of 20mg/kg/day in two divided dose for 14 days. The mean time of defervesence was 4.05+1.14 days with azithromycin and 3.41+0.95 with cefixime respectively. The minimum defervesence time was 02 days and maximum defervesence time was 07 days. Clinical cure rate was 87% in azithromycin group and 93% in cefixime group. No serious adverse effect was noted related to azithromycin and cefixime therapy except nausea, vomiting, diarrhoea and jaundice. It was found that azithromycin is almost as effective as cefixime in the treatment of typhoid fever.

Development of electrochemical sensors for quick detection of environmental (soil and water) NPK ions.

All over the world, technology is becoming more and more prevalent in agriculture. Different types of instruments are already being used in this sector. For the time being, every farmer is trying to produce more crops on a piece of land. Eventually, soil loses its nutrients; however, to grow more crops, farmers use more fertilizers without knowing the proper conditions of the soil in real time. To overcome this issue, many scientists have recently focused on developing electrochemical sensors to detect macronutrients, i.e., nitrogen (N), phosphorus (P), and potassium (K), in soil or water rapidly. In this review, we focus mainly on the recent developments in electrochemical sensors used for the detection of nutrients (NPK) in different types of samples. As it is outlined, the use of smart and portable electrochemical sensors can be helpful for the reduction of excess fertilizer and can play a vital role in maintaining suitable conditions in soils and water. We are optimistic that this review can guide researchers in the development of a portable and suitable NPK detection system for soil nutrients.

Correction: Development of electrochemical sensors for quick detection of environmental (soil and water) NPK ions.

[This corrects the article DOI: 10.1039/D4RA00034J.].

Comparison of trabeculectomy with mitomycin-C versus medical treatment in moderate stage of steroid induced glaucoma.

This prospective, comparative and interventional study was done to compare the effects of Trabeculectomy with Mitomycin-C and medical treatment with Timolol maleate 0.5% by controlling IOP (intra ocular pressure) and assessing the visual acuity (VA) and mean sensitivity (MS) of visual field in moderate stage of steroid induced glaucoma and conducted in the Department of Ophthalmology, Bangabandhu Sheikh Mujib Medical University, Dhaka, from July 2004 to June 2009. Sixty eyes of thirty patients with glaucoma due to use of topical steroids for >1 year. IOP range was 22-30 mm of Hg, visual field with (MD) mean deviation >6 to 12 dB and (MS) mean sensitivity >12-21dB, C:D ratio 0.7-0.8 and visual acuity 6/9 to 6/6 were included in this study. At first, topical steroid was stopped. Sample was collected in lottery method. Patients were divided into two groups. In Group I, 30 eyes were treated with Timolol maleate 0.5%. In Group II, 30 eyes were treated surgically by Trabeculectomy with Mitomycin-C. Follow-up were done on 1st POD, after 7 days, 1 month, 3 months and 6 months. Successful IOP control (<15mm of Hg) were achieved in 23 eyes (77%) in Group I and 30 eyes (100%) in Group II and were highly significant (p<0.001). Visual acuity and mean sensitivity also improved more in Group II than the Group I. It was also highly significant (p<0.001). So, Trabeculectomy with mitomycin-C is effective procedure in comparison to medical treatment for steroid induced glaucoma.

Nanostructured wearable electrochemical and biosensor towards healthcare management: a review.

In recent years, there has been a rapid increase in demand for wearable sensors, particularly these tracking the surroundings, fitness, and health of people. Thus, selective detection in human body fluid is a demand for a smart lifestyle by quick monitoring of electrolytes, drugs, toxins, metabolites and biomolecules, proteins, and the immune system. In this review, these parameters along with the main features of the latest and mostly cited research work on nanostructured wearable electrochemical and biosensors are surveyed. This study aims to help researchers and engineers choose the most suitable selective and sensitive sensor. Wearable sensors have broad and effective sensing platforms, such as contact lenses, Google Glass, skin-patch, mouth gourds, smartwatches, underwear, wristbands, and others. For increasing sensor reliability, additional advancements in electrochemical and biosensor precision, stability in uncontrolled environments, and reproducible sample conveyance are necessary. In addition, the optimistic future of wearable electrochemical sensors in fields, such as remote and customized healthcare and well-being is discussed. Overall, wearable electrochemical and biosensing technologies hold great promise for improving personal healthcare and monitoring performance with the potential to have a significant impact on daily lives. These technologies enable real-time body sensing and the communication of comprehensive physiological information.

Copper oxide nanoflowers/poly-l-glutamic acid modified advanced electrochemical sensor for selective detection of l-tryptophan in real samples.

The main objective of this research work is to develop a low-cost sensor to detect l-tryptophan (L-tryp) in real sample medium based on a modified glassy carbon electrode. For this, copper oxide nanoflowers (CuONFs) and poly-l-glutamic acid (PGA) were used to modify GCE. The prepared NFs and PGA coated electrode was characterized using field emission scanning electron microscope (FE-SEM) with energy dispersive X-ray (EDX) and attenuated total reflectance Fourier transform infrared (ATR-FTIR) spectroscopy. Furthermore, the electrochemical activity was performed by cyclic voltammetry (CV), differential pulse voltammetry (DPV) and electrochemical impedance spectroscopy (EIS). The modified electrode showed excellent electro-catalytic activity towards L-tryp detection in PBS solution at neutral pH 7.0. Based on the physiological pH condition, the proposed electrochemical sensor can detect L-tryp concentration with a linear range of 1.0 × 10-4-8.0 × 10-8 molL-1 with having a detection limit of 5.0 × 10-8 molL-1 and sensitivity of 0.6µA/µMcm2. The selectivity of L-tryp was tested with a mixture of salt and uric acid solution at the above conditions. Finally, this strategy demonstrated excellent recovery value in real sample analysis like milk and urine.

Zinc oxide nanorod/rutin modified electrode for the detection of Thiourea in real samples.

In this work, a novel electrochemical detection strategy was developed based on a metal-organic framework of zinc oxide nanorod nanoparticles and rutin for selective screening of Thiourea as toxic chemicals. The zinc oxide nanorod were synthesized by following direct chemical precipitation methods and characterized by X-ray diffraction and X-ray photoelectron spectroscopy analysis. The surface of modified electrodes was also characterized by field emission scanning electron microscopes, energy-dispersive X-ray spectroscopy, and attenuated total reflectance flourier transform infrared spectroscopy. Furthermore, the electrochemical activity of the developed sensor was tested by cyclic voltammetry, differential pulse voltammetry, and electrochemical impedance spectroscopy. The modified electrode showed outstanding electro-catalytic activity towards the detection of Thiourea in phosphate buffer saline at a high pH level of 12.0. The proposed sensor showed a linear range of linearity in a concentration ranging from 5.0 × 10-6 - 900 × 10-6 molL-1 and a detection limit of 2.0 × 10-6 molL-1. Moreover, the selectivity of the developed electrochemical sensor was investigated for the detection of Thiourea in the presence of organic compounds and a group of anions. Furthermore, the proposed strategy demonstrated an excellent recovery value in the spiked farmland water and fruit juice sample.

Effect of topical Beta blocker (Timolol maleate 0.5%) in primary open angle glaucoma.

The study was undertaken to measure the effects of Beta blocker (Timolol maleate 0.5%) in moderate and advanced stage of primary open angle glaucoma by controlling intra-ocular pressure (IOP) and assessing the visual acuity (VA) and mean sensitivity (MS) of visual field. Study was done in the department of Ophthalmology, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka from January 2002 to December 2005. It was a Prospective and interventional study. Thirty patients of bilateral primary open angle glaucoma were treated medically by B-blocker (Timolol maleate 0.5%) two times daily. Follow up were done after 7 days, 1 month, 3 months and 6 months. Before treatment Intra ocular pressure (IOP) range was 22-30 mm of Hg (mean 23.40 ± 2.04). After beta-blockers IOP reduced to the range of 10-20mm of Hg (mean 13.12 ± 2.01) which was statistically significant (p>0.02) in moderate stage & 8-18 mm Hg (mean 13.50 ± 2.0) in advance stage which was also statistically significant (p<0.02). VA and MS also improved in 15 eyes (50%), remained unchanged in 9 eyes (30%) and deteriorated in 6 eyes (20%) in moderate stage and also improved in 15 eyes (50%), remained unchanged in 6 eyes (20%) and deteriorated in 9 eyes (30%) in advanced stage. Success rate was 80% in moderate (p>0.02) & 70% in advanced stage (p<0.02) and which was statistically significant.

Beta thalassemia in a tertiary care hospital with their chelation habit.

Beta-thalassemia which is one of the most common genetic disorders in Bangladesh encompasses a group of monogemic diseases that have reduced synthesis or no synthesis of one or more globin chain of haemoglobin. The defects involved are extremely heterogenous and give rise to a large phenotypic spectrum with patients that are almost asymptomatic to cases in which regular blood transfusions are required to sustain life. The aim of the study is to estimate the frequency of beta thalassemia among the blood recipients in the Day Care Centre of Transfusion Medicine Department of Mymensingh Medical College Hospital from July, 2009 to June, 2010 along with their chelation habit. Retrospective cross-sectional study with the sample size of 784, clinical and family data was collected and descriptive statistics were done in the Laboratory of Transfusion Medicine Department. Among the 784 subjects, the beta thalassemia was 521 (66.46%), among the thalassemic patients only 59(11.32%) take injection Dysferrioxamine (Dysferol), the iron chelating agent. Male are predominant than female (63.53%). Those of the affected patients 67.18% were in age group 6 to 20 years. Although beta thalassemia is one of the first monogemic diseases and represents a global health problem, only recently has the scientific community started to focus on the real molecular mechanisms that underline this disease, opening new & exciting therapeutic perspectives for thalassemic patients worldwide. It is concluded from our study that availability of blood transfusion facilities along with an orally and cheaper iron chelator is an urgent need to ensure the management of needy thalassemic patients in Bangladesh.

Chikungunya virus infection, a threat to public health.

Many countries in the world have reported human infections by chikungunya virus (CHIKV) a mosquito-borne togavirus belonging to the genus alpha virus. After half a century of focal out breaks of acute febrile poly arthralgia, the disease had spread unexpectedly in the past decade with large outbreaks in Africa around the Indian Ocean and in Bangladesh. In Asia, CHIKV is thought to be transmitted by the same mosquito as dengue, Aedes aegypti and Aedes albopictus. Due to similarities in clinical presentation with dengue, limited awareness and a lack of laboratory diagnostic facilities, CHIKV is probably often under diagnosed or misdiagnosed as dengue. Treatment is supportive. The prognosis is generally good although some patients experience chronic arthritis. There is no vaccine or antiviral therapy against CHIKV. Early identification of disease and control of vector will prevent the spread of disease.

Iron chelation therapy and thalassemia - an overview.

New developments in the epidemiology, treatment and prognosis of thalassemia have dramatically altered the approach to the care of affected patients. In the last 30 years, conventional treatment of ß-thalassemia major, based primarily on regular blood transfusions and iron chelation therapy with desferrioxamine (DFO) has markedly improved the prognosis of the disease. Adequate administration of parenteral DFO reduces or prevents iron accumulation. The unavailability of DFO (dysferol) for most patients with thalassemia major and the failure of prescribed therapy to prevent complications in other patients have led to a search for alternative iron chelators; one of them, deferiprone (DFP) has been commercially available. Patients may ultimately benefit from having a choice between several chelators, including orally active drugs. Combination therapy and organ-targeted chelation, may soon have a considerable impact on the therapeutic outcome and quality of life of patients with thalassemia.

Urinary tract infection in children in a tertiary level hospital in bangladesh.

An observation study was carried out in the department of Paediatrics in Mymensingh Medical College Hospital, Mymensingh regarding urinary tract infection (UTI) in children aged ≤15 years from January 2008 to December 2008. The objectives of this study were to review symptoms, causative agents, antimicrobial sensitivity test, abnormalities of urinary tract and treatment of children with UTI. Fifty cases of childhood UTI, based on urine routine examination and culture, were analyzed and male female ratio was 1:1.3. Sixteen (32%) children were less than one year old. Fever was the most common clinical presentation (82%). Pyuria was detected in 92% of cases. Most common causative organism was Eschericia coli (E. coli) (70%). Susceptibility of E. coli to ceftriaxone, levofloxacin, amikacin and nitrofurantoin was greater than 80% and less susceptible to cotrimoxazole, ampicillin, cephradine and ciprofloxacin. Most of the patients became afebrile within 5 days after starting antimicrobial therapy.

Vas Deferens Calcification in a Diabetic CKD: An Incidental Finding.

Vas deferens calcification is a very rare condition. The causes can be categorized as inflammatory and non-inflammatory type. We are presenting such a non inflammatory type of bilateral vas calcification in a diabetic chronic kidney diseases (CKD) patient. Presented patient a 50 years old man admitted in Samorita Hospital Ltd., Dhaka, Bangladesh on 03 August 2014 in cabin - 537 with registration number 1904/14. He was labeled as Diabetes mellitus (DM), Hypertension (HTN), CKD & Urinary tract infection (UTI). Vas deferens calcification was diagnosed incidentally by X-ray KUB. Subsequently we have discussed all possible causes in this report. The purpose of presenting this rare imaging finding is to emphasize the under diagnosis of the disease and causes. It can also be diagnosed by simple, easily available and cheap investigations like Plain X ray KUB.

Diagnostic efficacy of Aldehyde test in late cases of Kala-azar.

This case control study was carried out in the Paediatric wards of Mymensingh Medical College Hospital for a period of one year from April 2002 to March 2003 to determine the sensitivity, specificity and predictive values of Aldehyde test in the diagnosis of Kala-azar. A total of seventy five febrile cases of Kala-azar from Paediatric wards were enrolled in the study and Seventy five controls having splenomegaly with or without fever were also included from the same source. Aldehyde test was done in both cases and controls. Diagnosis of Kala-azar was confirmed by demonstration of Leish-man-Don-o-van body (LD) in bone marrow or splenic aspirates. Out of 75 parasitologically proven cases of Kala-azar, AT was positive in 56 cases. The sensitivity irrespective of duration of illness was 74.6%. We found sensitivity of AT increases with the duration of illness where AT was sensitive in 34.7% cases having fever for less than 3 months, 90.90% with fever for 3 months to less than 6 months and 100% with fever for 6 months or more in duration. Specificity of AT was calculated as 96% with positive and negative predictive values of 94.9% and 79.1% respectively. So AT is a very sensitive and specific test with high positive and negative predictive values. Considering the cost, availability, simplicity, sensitivity, and specificity we would recommend the Aldehyde test as an important diagnostic tool for field diagnosis of Kala-azar especially after three months of febrile illness.

Efficacy of azithromycin in the treatment of childhood typhoid Fever.

An intervention study was carried out in Paediatric wards for a period of one year from January 2003 to December 2003 to determine the efficacy and safety of azithromycin in the treatment of uncomplicated childhood typhoid fever. A total of 50 cases were enrolled in the study. The inclusion criteria of the cases were: documented fever for more than 7 days plus two or more of the following clinical features: toxic appearance, abdominal tenderness, hepatomegaly, splenomegaly, diarrhoea, constipation and coated tongue plus positive Widal test and/or blood culture positivity. Patients who had complication like gastrointestinal tract (GIT) haemorrhage; intestinal perforation and/or shock were excluded from the study. Data were collected in a structured questionnaire. Azithromycin was given at a dose of 10mg/kg /day for a period of 07 days. The time to defervescence was 3.82+/-1.49 days. The minimum defervescence time was 02 days and maximum was 07 days. Clinical cure rate was 94%. No serious adverse effect was noted related to azithromycin therapy except nausea, vomiting, and jaundice. Prior treatment with antibiotics did not affect defervescence time (P>0.05). Pre-treatment febrile period has got positive and linear correlation with clinical response (r = +0.593). It was found that once daily administration of oral azithromycin for seven days in the treatment of uncomplicated typhoid fever was effective and reasonably safe.

Evaluation of stentangioplasty in university cardiac center.

In this ongoing prospective study conducted in University Cardiac Center, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from July 2004 to January 2006. Fifty (50) patients (mean age 56+/-7.2 years) underwent stentangioplasty were evaluated. The study group of 50 patients consisted of 42 (84%) men and 08 (16%) women. The aim of this study was to evaluate in-hospital success, failure and complications during the procedures. About risk factors 19(38%) had hypertension, 13(26%) were smoker, 11(22%) suffered from diabetes mellitus, 05(10%) had family history of ischaemic heart disease. Average left ventricular ejection fraction was 54+/-7. Target vessel percutaneous coronary angioplasty (PTCA) were done in 61 vessel, intracoronary stent implanted in 58 vessels, direct stenting were done in 35 cases, failed PTCA were in 03(6%) cases and two had dissection. The native vessels had a mean reference diameter of 2.91 mm and their luminal diameter increased significantly after percutaneous coronary intervention (PCI). All the patients were discharged by one to three days of the procedure with improvement of their clinical condition. In conclusion, intracoronary stent deployment in coronary artery stenosis following balloon angioplasty is a valid and beneficial strategy with good in-hospital results.

Photolysis method for determination of the tetramer-dimer dissociation constant of deoxyhemoglobin.

A new method for determination of the tetramer-dimer dissociation constant Ku4.2 of deoxyhemoglobin is described. The method involves photolysis of hemoglobin solutions containing a few percent of bound CO (e.g. less than 3%). Under these conditions the nature of the observed CO rebinding is primarily determined by the properties of the dominant species, deoxyhemoglobin. The method makes use of the 30-fold difference in the rate constant describing CO binding to hemoglobin dimers and deoxyhemoglobin tetramers. Because of this large difference in rate constants CO rebinding is made significantly more rapid by the presence of even small concentrations of dimers. Treating this reaction as CO binding to a mixture of hemoglobin dimers and tetramers allows the determination of Ku4.2. Data is presented showing application of the method to human deoxyhemoglobin in the range from pH 9.5 to 11.2.

Signal Transduction Pathways Leading to Heat Shock Transcription.

Heat shock proteins (HSP) are essential for intracellular protein folding during stress and protect cells from denaturation and aggregation cascades that can lead to cell death. HSP genes are regulated at the transcriptional level by heat shock transcription factor 1 (HSF1) that is activated by stress and binds to heat shock elements in HSP genes. The activation of HSF1 during heat shock involves conversion from an inert monomer to a DNA binding trimer through a series of intramolecular folding rearrangements. However, the trigger for HSF1 at the molecular level is unclear and hypotheses for this process include reversal of feedback inhibition of HSF1 by molecular chaperones and heat-induced binding to large non-coding RNAs. Heat shock also causes a profound modulation in cell signaling pathways that lead to protein kinase activation and phosphorylation of HSF1 at a number of regulatory serine residues. HSP genes themselves exist in an accessible chromatin conformation already bound to RNA polymerase II. The RNA polymerase II is paused on HSP promoters after transcribing a short RNA sequence proximal to the promoter. Activation by heat shock involves HSF1 binding to the promoter and release of the paused RNA polymerase II followed by further rounds of transcriptional initiation and elongation. HSF1 is thus involved in both initiation and elongation of HSP RNA transcripts. Recent studies indicate important roles for histone modifications on HSP genes during heat shock. Histone modification occurs rapidly after stress and may be involved in promoting nucleosome remodeling on HSP promoters and in the open reading frames of HSP genes. Understanding these processes may be key to evaluating mechanisms of deregulated HSP expression that plays a key role in neurodegeneration and cancer.