A comprehensive review on sustainable coastal zone management in Bangladesh: Present status and the way forward.

Bangladesh, a coastal developing nation with a diverse sustainable biodiversity of natural resources is currently focused upon by international communities as a result of its high potential of the coastal zone (CZ) with natural gas. Sustainable Coastal Zone Management (SCZM) is key to its national development. SCZM refers to the management of coastal resources in order to provide secure and alternative livelihoods, as well as to manage all types of coastal hazards and social and cultural well-being in order to ensure long-term productivity and minimize environmental impact. This paper aims to delineate the current initiatives and status of coastal management in Bangladesh, highlighting key issues such as climate changes, sea level rise, tropical cyclones, coastal and marine pollution, coastal erosions, saltwater intrusions, and mangrove degradations as well as the future trend in Bangladesh which will facilitate sustainable development by emphasizing the social, ecological, and economic pillars of sustainability. Unsustainable coastal development practices in Bangladesh are going to damage the coastal ecosystems, particularly mangrove forests and coral reefs, which provide protection against tropical cyclones caused by global climate change and coastal erosions. The paper concludes by outlining a roadmap toward achieving SCZM in Bangladesh. The road to achieving SCZM requires collaboration, integration of scientific research, policy frameworks, community engagement, capacity building, and long-term commitment from all stakeholders involved. So, it is required to address all kinds of coastal issues and reframes all existing coastal management practices to ensure a healthy productive ecosystem to achieve SCZM as well as the sustainable development of the country.

The pervasiveness of microplastic contamination in the gastrointestinal tract of fish from the western coast of Bangladesh.

This study investigated the prevalence of microplastics (MPs) in the gastrointestinal tract (GIT) of fish from the western coast of Bangladesh, the world's largest mangrove ecosystem. Altogether, 8 different species of fish (5 demersal and 3 pelagic) were examined. Microplastics were detected in every individual fish with an average abundance of 7.1 ± 3.14 particles per specimen. The demersal species were observed to consume more microplastics (7.78 ± 3.51) than the pelagic species (5.92 ± 2.06). Moreover, small-sized fish was found to accumulate higher MPs/body weight than large-sized fish. Polypropylene was the most abundant polymer type (45 %) and fiber was the most prevalent shape (71 %). SEM analysis revealed cracks, pits, and foreign particles on the microplastics' surface, representing their ability to bear organic pollutants and heavy metals. This study will be a source of information for future research and a guide for policy-makers to take better actions to protect and restore marine resources.

Medical Knowledge versus Perception of Patients with Abdominal Gas in a Tertiary Level Hospital of Bangladesh.

Every human being has gas in abdomen. But patients try to correlate varieties of symptoms with abdominal gas. So this cross sectional symptom based study was designed to see the patients view regarding abdominal gas and its relation with medically explained symptoms at the out patient department of North East Medical College, Sylhet from January 2017 to December 2019. Consecutive patients presenting with complain of abdominal gas were included in this study. Their demographic information and explanation of symptoms resulting from abdominal gas were recorded on a pre-designed data sheet. Statistical analysis was done using SPSS 20.0 version. Total 346 patients, male 239(69.1%), female 107(30.9%), age varying from 17-83 years (mean 38.27) were enrolled. Common symptoms were bloating (fullness) of abdomen (194, 56.1%), abdominal pain (164, 47.41%), belching or eructation (149, 43.1%), heart burn (137, 39.6%), anorexia (124, 35.8%), nausea (120, 34.7%), noisy bowel (88, 25.4%), chest pain (79, 22.8%), headache (56, 16.2%), whole body pain (58, 16.8%), incomplete bowel evacuation (185, 53.5%), excess flatus (76, 22.4%), movement of gas to different part of body including head 87(25.1%) and expulsion of hot air from ear, nose and head in 69(19.9%) patients. Among them 107(30.9%) patients believed abdominal gas to be a curable disease with treatment and 222(64.2%) believed it to be a relapsing disease even after treatment. And 307(88.7%) patients were taking proton pump inhibitor (PPI) as its remedy regularly. Most of the symptoms of patients can be explained by abdominal gas. Again some patients have a misperception regarding some symptoms like heart burn, noisy bowel and sense of incomplete bowel evacuations are also related with abdominal gas. But in some instances causal relations with patients' symptoms and abdominal gas could not be explained by medical knowledge. These differences in perceptions might be related to their personal thinking and social, cultural, educational, economic condition.

What does family involvement in care provision look like across hospital settings in Bangladesh, Indonesia, and South Korea?

BACKGROUND: Family members provide care whilst staying in the patient's room across a range of cultural settings, irrespective of resource availability in many Asian countries. This has been reported as a contributing factor to the spread of several outbreaks, including COVID-19. Despite these reports, very little is known about the risk of healthcare-associated infection (HAI) transmission related to the involvement of family and private carers in the clinical setting. As a starting point to understanding this issue, this study aimed to provide insights regarding the patient care activities undertaken by family and private carers and the guidance provided to these carers around infection control measures in hospitals located in Bangladesh, Indonesia, and South Korea. METHOD: A qualitative study involving 57 semi-structured interviews was undertaken in five tertiary level hospitals across the selected countries. Two groups of individuals were interviewed: (1) patients and their family carers and private carers; and (2) healthcare workers, including doctors, nurses, hospital managers and staff members. Drawing upon the principles of grounded theory, an inductive approach to data analysis using thematic analysis was adopted. RESULTS: Five main themes were generated from the analysis of the data: (1) expectation of family carers staying with a patient; (2) residing in the patient's environment: (3) caring activities undertaken by family carers; (4) supporting and educating family carers and (5) communication around healthcare-associated infection and infection prevention and control. CONCLUSION: Based on the types of activities being undertaken, coupled with the length of time family and private carers are residing within the clinical setting, coupled with an apparent lack of guidance being given around IPC, more needs to be done to ensure that these carers are not being inadvertently exposed to HAI's or other occupational risks.

Recent advances and applications of synthetic diamonds in solid-phase extraction and high-performance liquid chromatography.

Since the advent of diamond-based adsorbents in the late 1960s, the interest in their use for solid-phase extraction (SPE) and high-performance liquid chromatography (HPLC) has steadily increased. This is primarily due to their unique properties, such as extreme chemical and thermal stability, high mechanical strength and biocompatibility, and complex mixed-mode retention mechanisms. Currently, the most commonly used synthetic diamonds in SPE and HPLC are detonation nanodiamonds (DND), high-pressure high-temperature (HPHT) diamonds, and chemical vapour deposition (CVD) diamonds. These diamonds have been either used as individual particles (in both modified and unmodified forms), or for surface modification, or entrapped within composites and core-shell particles to develop new diamond-based adsorbents. These diamond-based adsorbents have been used for a variety of applications, including streamlined proteome analysis; extraction of anions, cations, actinides, uranium, lanthanides, alkaline earth metals, transition metals, and post-transition metals; and development of reversed-phase, normal phase, hydrophilic interaction, ion chromatography, and mixed-mode liquid chromatography columns, to name but a few. These varied applications of different types of diamonds are typically governed by their specific properties. This review discusses the various surface and bulk properties of DND, HPHT diamonds, and CVD diamonds that facilitate or limit their use in different SPE and HPLC based applications.

Recent advances in stir-bar sorptive extraction: Coatings, technical improvements, and applications.

Stir-bar sorptive extraction (SBSE) is a popular solvent-less sample preparation method, which is widely applied for the sampling and preconcentration of a wide range of non-polar solutes. A typical stir-bar for SBSE is composed of a polydimethylsiloxane (PDMS) film, coated onto a glass jacket with an incorporated magnet core. Sampling is carried out by direct immersion or by exposing the stir-bar to the headspace of the sample. To-date the majority of reported SBSE devices have used PDMS as the sorbent, with a few alternative commercially SBSE coatings available (such as polyethylene glycol and polyacrylate), which limits the applicability of SBSE to more polar and hydrophilic solutes. The interest in more selective extraction has been the driving force behind the recent development of novel SBSE coatings, particularly those exhibiting selectivity towards more polar solutes. During the last decade, a significant number of novel SBSE coatings were introduced utilising different fabrication approaches, including surface adhesion, molecular imprinting, sol-gel technology, immobilised monoliths, and solvent exchange processes. A range of nano- and micro-carbon-based materials, functional polymers, metal organic frameworks (MOFs), and inorganic nanoparticles have been employed for this purpose. Some of these SBSE coatings have exhibited higher thermal and chemical stability and delivered wider selectivity profiles. This review aims to summarise these significant developments, reported over the past six years, with specific attention to novel materials and selectivity for extending the potential applications of SBSE.

Development of polydimethylsiloxane-microdiamond composite materials for application as sorptive devices.

The development and application of non-porous and porous sorptive rods, comprised of polydimethylsiloxane-microdiamond (PDMS-MD) composites, is reported. The PDMS-MD composites were made porous using inorganic salt (NaCl and NaHCO3) particles as dissolvable templates. Materials with pore size of ~40 µm down to ~5 µm were produced. The advantages of incorporating up to ~60%microdiamond (2-4 µm) into PDMS included: (1) significant increase in the density, which saw the rods sink within the aqueous sample without addition of secondary metal or glass materials, (2) significant improvement in mechanical stability (the porous composite rods could be thermally treated multiple times before application, unlike porous PDMS), (3) increased thermal stability up to 450-500 °C with only 6% weight loss of volatile components, and (4) higher thermal conductivity, estimated to be 108% higher than for PDMS. The PDMS-MD investigated as a sorbent for extraction, followed by liquid desorption and GC-FID analysis. Recovery of the sorbent for test solutes, isoamyl acetate, ethyl hexanoate, ethyl octanoate, ethyl decanoate, and phenethyl acetate, was found to range from ~87% to >100, with RSD of 2.10-12.50% in synthetic wine samples. Non-porous composite rods provided similar % recoveries to a commercial sorptive device (PDMS Twister), whereas porous rods showed improved % recovery for most of the test solutes (>10-20%) when applied under similar conditions. The limits of detection (LOD) for the above solutes within the developed method ranged from 0.60 to 27.30 µg L-1). Application of the PDMS-MD-LD-GC-FID method to white wine samples demonstrated how the PDMS-MD composite material can be applied as a robust and an efficient sorptive phase for trace chemical analysis.

Electric field encephalography for brain activity monitoring.

OBJECTIVE: We describe an early-stage prototype of a new wireless electrophysiological sensor system, called NeuroDot, which can measure neuroelectric potentials and fields at the scalp in a new modality called Electric Field Encephalography (EFEG). We aim to establish the physical validity of the EFEG modality, and examine some of its properties and relative merits compared to EEG. APPROACH: We designed a wireless neuroelectric measurement device based on the Texas Instrument ADS1299 Analog Front End platform and a sensor montage, using custom electrodes, to simultaneously measure EFEG and spatially averaged EEG over a localized patch of the scalp (2 cm × 2 cm). The signal properties of each modality were compared across tests of noise floor, Berger effect, steady-state visually evoked potential (ssVEP), signal-to-noise ratio (SNR), and others. In order to compare EFEG to EEG modalities in the frequency domain, we use a novel technique to compute spectral power densities and derive narrow-band SNR estimates for ssVEP signals. A simple binary choice brain-computer-interface (BCI) concept based on ssVEP is evaluated. Also, we present examples of high quality recording of transient Visually Evoked Potentials and Fields (tVEPF) that could be used for neurological studies. MAIN RESULTS: We demonstrate the capability of the NeuroDot system to record high quality EEG signals comparable to some recent clinical and research grade systems on the market. We show that the locally-referenced EFEG metric is resistant to certain types of movement artifacts. In some ssVEP based measurements, the EFEG modality shows promising results, demonstrating superior signal to noise ratios than the same recording processed as an analogous EEG signal. We show that by using EFEG based ssVEP SNR estimates to perform a binary classification in a model BCI, the optimal information transfer rate (ITR) can be raised from 15 to 30 bits per minute-though these preliminary results are likely sensitive to inter-subject variations and choice of scalp locations, so require further investigation. SIGNIFICANCE: Enhancement of ssVEP SNR using EFEG has the potential to improve visually based BCIs and diagnostic paradigms. The time domain analysis of tVEPF signals shows robust features in the electric field components that might have clinical relevance beyond classical VEP approaches.

Sexual dimorphism of AMBRA1-related autistic features in human and mouse.

Ambra1 is linked to autophagy and neurodevelopment. Heterozygous Ambra1 deficiency induces autism-like behavior in a sexually dimorphic manner. Extraordinarily, autistic features are seen in female mice only, combined with stronger Ambra1 protein reduction in brain compared to males. However, significance of AMBRA1 for autistic phenotypes in humans and, apart from behavior, for other autism-typical features, namely early brain enlargement or increased seizure propensity, has remained unexplored. Here we show in two independent human samples that a single normal AMBRA1 genotype, the intronic SNP rs3802890-AA, is associated with autistic features in women, who also display lower AMBRA1 mRNA expression in peripheral blood mononuclear cells relative to female GG carriers. Located within a non-coding RNA, likely relevant for mRNA and protein interaction, rs3802890 (A versus G allele) may affect its stability through modification of folding, as predicted by in silico analysis. Searching for further autism-relevant characteristics in Ambra1+/- mice, we observe reduced interest of female but not male mutants regarding pheromone signals of the respective other gender in the social intellicage set-up. Moreover, altered pentylentetrazol-induced seizure propensity, an in vivo readout of neuronal excitation-inhibition dysbalance, becomes obvious exclusively in female mutants. Magnetic resonance imaging reveals mild prepubertal brain enlargement in both genders, uncoupling enhanced brain dimensions from the primarily female expression of all other autistic phenotypes investigated here. These data support a role of AMBRA1/Ambra1 partial loss-of-function genotypes for female autistic traits. Moreover, they suggest Ambra1 heterozygous mice as a novel multifaceted and construct-valid genetic mouse model for female autism.

A randomized phase III study of 72 h infusional versus bolus bleomycin in BEP (bleomycin, etoposide and cisplatin) chemotherapy to treat IGCCCG good prognosis metastatic germ cell tumours (TE-3).

BACKGROUND: Bleomycin is an integral part of combination chemotherapy in germ cell tumours. Pulmonary toxicity often necessitates drug cessation and death occurs in 1%-2% of patients. A continuous infusion of bleomycin might reduce lung toxicity when compared with the conventional weekly boluses given as part of standard BEP chemotherapy. PATIENTS AND METHODS: A phase 3 trial was conducted based on 212 men with IGCCCG good prognosis metastatic germ cell tumours with 1 : 1 randomization. They were stratified for age, smoking history and renal function. Patients received either conventional BEP with weekly bleomycin (30 000 units/week i.v. bolus) or as a 90 000 unit infusion on day 1 over 72 h. The primary endpoint was CT assessed lung toxicity, secondary endpoints included progression-free survival (PFS), changes in lung function testing and quality of life. Repeated measures mixed effects model was used to analyse the data. RESULTS: CT assessed lung toxicity for the infusional and conventional arm patients were respectively 80% versus 62% at the end of treatment and 54% versus 51% at 1-year post-treatment. There was no significant difference between the two arms for CT assessed lung toxicity (estimated regression coefficient = 1.4, 95% CI: -0.36, 3.16). Older patients had higher toxicity (coefficient = 4.81, 95% CI: 3.04, 6.58). Lung toxicity increased after 1 cycle and peaked at end of treatment (P ≤ 0.002) and then declined. Lung function testing did not predict for subsequent lung damage. The median follow-up was 2.5 years. Two-year PFS rate (infusional: 93%, conventional: 94%; hazard ratio =0.91, 95% CI: 0.33, 2.52) was similar. Cough (P = 0.002) but not shortness of breath (P ≥ 0.09) was associated with bleomycin toxicity. CONCLUSIONS: Infusional bleomycin has no advantage over standard administration. It supports abandoning routine pulmonary function testing, instead the presence of cough should be sought and the early use of CT scanning of the chest to evaluate potential lung toxicity is preferred.

Study on Association of Maternal Serum Triglyceride with Pre-eclampsia.

Till now pre-eclampsia is a disease of multiple theories. This case control study was carried out in the department of Obstetrics and Gynaecology of Bangabandhu Sheikh Mujib Medical University Hospital and Dhaka Medical College Hospital, from January 2006 to December 2007 to determine the association of maternal serum triglyceride with pre-eclampsia. Ninety pregnant women were studied, among them 45 patients were pre-eclamptic and served as case and 45 normal healthy pregnant women served as control. Estimation of serum triglyceride levels of all study patients was done with the help of enzymatic method. The mean (± SD) systolic blood pressure was 152.4 ± 19.8 mmHg in study group and 112.0 ± 8.9 mmHg in control group (p<0.05). Similarly the mean (± SD) diastolic blood pressure was 103.1 ± 12.2 mmHg in case group and 75.5 ± 6.6 mmHg in control group (p<0.05). Serum triglyceride level was more than the normal reference value in pre-eclamptic group. The mean (± SD) serum triglyceride level was 242.9 ± 36.8 mg/dl in case group and 184.6 ± 12.5mg/dl in control group. Statistically the difference was significant (p<0.05). The level of serum triglyceride positively correlated with the rise of blood pressure and degree of albuminuria. Thus serum triglyceride level increase in pre-eclampsia and the level correlate with the severity of the disease.

Impact of post-operative radiation on coronary arteries in patients of early breast cancer: A pilot dosimetric study from a tertiary cancer care center from India.

BACKGROUND: The significant impact of postoperative radiotherapy (PORT) on cardiac morbidity in patients of early breast cancer (EBC) undergoing breast-conserving surgery has been shown in different studies. The present study was conducted to assess the impact of surgery and the side of involvement on radiation dose to left anterior descending artery (LAD) and Left circumflex coronary artery (LCx). MATERIALS AND METHODS: Totally, 58 patients of EBC were randomly chosen for this dosimetric study and planned with tangential field technique without intensity modulation (IM). Heart, LAD, and LCx (n = 55) were contoured. Dose volume histograms were analyzed to determine the Dmax (maximum dose) and Dmean (mean dose) of LAD and LCx. Student's t-test was used for comparative analysis of the means. RESULTS: The mean Dmax of LAD for left (L) EBC was 3.17 Gray (Gy) while for right (R) EBC it was 0.86 Gy (P = 0.007; 95% C.I, 1.14-3.48). The mean Dmean of LAD for L-EBC and R-EBC were 1.97 Gy and 0.79 Gy, respectively (P = 0.029; 95% C.I, 0.77-1.60). The mean-Dmax of LCx for patients with L-EBC (2.9 Gy; range: 1.2-4.35 Gy) was statistically higher than that for R-EBC (1.3 Gy; range: 0.7-3.2 Gy) (P = 0.045). The mean-Dmean of LCx for L-EBC (2.1 Gy; range: 0.6-3.6 Gy) was also significantly higher than that of L-EBC (0.9 Gy; range: 0.7-2.1 Gy) (P = 0.03). There was no significant impact of the pattern of surgery on LAD dose, but significance was noted for LCx dose parameters (P = 0.04 and 0.08 for m-Dmax and m-Dmean of LCx). CONCLUSION: This pilot dosimetric study confirms the assumption that patients with left-sided EBC are at higher risk of developing long-term cardiac morbidity when treated with PORT due to increased dose to LAD.

Environmental risks associated with booster biocides leaching from spent anti-fouling paint particles in coastal environments.

Boat maintenance facilities in coastal areas contribute a significant amount of antifouling paint particles (APP) to coastal environments. Very few studies have concentrated on the leaching of booster biocides embedded in old paint particles. Therefore, this study attempted to assess the leaching of Dichlofluanid and Irgarol 1051 from APP collected from Mayflower Marina in southwest England. They were analyzed by GC-MS. A leaching experiment revealed that a considerable amount of Dichlofluanid (ca. 24 µg/L) leached from 0.4 g/L of APP after the first hour, followed by a marked decline in the amount measured in the water over time, almost degrading after 24 h in seawater, affording less of an environmental threat to non-target organisms. Conversely, Irgarol 1051 appeared to be persistent and continuously leached from the 0.4 g/L of APP even after 10 days, yielding a concentration of 0.61 µg/L in seawater, potentially posing a significant threat to the aquatic environment through leaching from APP.

Observational assessment and correlates to blood pressure of future physicians of Bengal.

INTRODUCTION: Hypertension is a modern day epidemic and growing public health problem. A sizable proportion of world populations suffer from prehypertension or hypertension. OBJECTIVES: The present study was carried out to detect the prevalence of undiagnosed hypertension among undergraduate medical students and to identify the associated risk factors. MATERIALS AND METHODS: The study was observational in nature and was done in medical colleges of Bengal. Study tool was a predesigned, pretested, validated, and semi-structured questionnaire containing both open-ended and close-ended questions. Data were collected through self-administration, clinical, and anthropometric examination. The data were then tabulated, analyzed and interpretation was done by using percentage and Chi-square test. RESULTS: Most of the students (63%) were young adults, predominantly males (67%) and day scholars (71%). Almost one-third of them either suffered from hypertension or at risk of hypertension. Hypertension was found higher among male students. Family history of hypertension or diabetes mellitus was not associated with hypertension. Vegetarian or nonvegetarian diet or extra-salt consumption was also not associated with hypertension. Smoking was shown positively associated with hypertension but alcohol consumption was not. Higher per capita monthly income and overweight or obesity were shown positively associated with hypertension. CONCLUSION: The overall prevalence of hypertension in this study was 13% and there were positive association of hypertension with multiple socio-demographic factors like age, sex, type of family, per capita monthly income, residence, BMI, smoking, etc.

Haemodynamic and end tidal CO2 changes during laparoscopic cholecystectomy under general anaesthesia.

A prospective observational study was done on 50 patients to investigate the haemodynamic and end tidal CO2 (EtCO2) changes in healthy patients without cardiopulmonary pathology during elective laparoscopic cholecystectomy in head up position under standard protocol of general anaesthesia. During surgery, intra abdominal pressure was maintained at 15 mmHg by a CO2 insufflator and minute ventilation was controlled with a constant tidal volume and fixed respiratory rate. Haemodynamic parameters, EtCO2, SpO2 and ECG were recorded before and after induction and positioning of the patients and at 5 minutes interval for the first 30 minutes, then 10 minutes interval for the rest of the period. Highly significant increase (p<0.001) in pulse rate, systolic, diastolic and mean arterial pressure occurred at 30 minutes after insufflations and positioning of the patient. A very highly significant (p<0.001) increase in EtCO2 from the base line was at 40 minutes after insufflations and positioning of the patients. There was no change in SpO2 and ECG. This study supports the significant physiological changes in terms of haemodynamic and EtCO2 during laparoscopic cholecystectomy and recommends the meticulous monitoring of these parameters during the surgery and balance the benefit of laparoscopy against the intra operative risk.

Electrosurgical smoke: a real concern.

Electrosurgical techniques including laser surgery have expanded greatly in recent years. Pyrolysis of tissue produces smoke. Recently the smoke is being analyzed using Gas Chromatography-Mass Spectrometry. The nature of smoke depends on the rise of temperature of tissue during electro-surgery. The smoke produced at high temperatures contains low concentration of Group-I carcinogens (IARC) such as Benzene, Hydrogen cyanide, Formaldehyde 1,3-Butadiene and Acrylonitrile. Bioaerosol produced at low temperature as in harmonic scissors may contain live multidrug resistant Mycobacterium tuberculosis, viral DNA of HBV, HCV, HIV and HPV. It also contains live malignant cells and dead cellular materials. These produce an unquantified infection risk. The obnoxious smoke causes ocular and upper respiratory tract irritation, creates visual problems for surgeons. Surgical masks are not capable of filtering the produced bioaerosol. Removal of smoke from the site of operation by local exhaust ventilation is not complete. When produced in a closed cavity as in laparoscopic surgery the patient also suffers from carboxyhaemoglobinaemia and methaemoglobinaemia. Methemoglobinaemia is not detected by standard pulse-oximetry. Laser smoke produces congestive interstitial pneumonia, bronchiolitis and emphysema in rats. Chromosomal aberration and sister chromatid exchange have been found in lymphocyte culture of operating room personnel. Occupational safety and health authorities like Occupational Safety and Health Administration (OSHA), National Institute for Occupational safety and Health (NIOSH), American National Standard Institute (ANSI) and Association of Operating room nurses (AORN) are trying to find effective ways for removal of smoke from site of operation and also the real risk to operating room personnel. Answer lies in minimizing the use of electrocautery whenever possible and completes removal of harmful smoke.

Haemodynamic and end tidal CO2 changes state after inflation and deflation of pneumatic tourniquet on extremities.

The use of a tourniquet for obtaining a bloodless field is an essential and accepted tool for extremity surgery. A prospective study was done on 30 adult patients undergoing elective limb surgery requiring tourniquet application for haemodynamic and End tidal CO2 (EtCO2) changes. After the induction of general anaesthesia a tourniquet was applied on the limb. There was gradual increase in heart rate & EtCO2 through out the whole period of tourniquet inflation. There was also significant increase of mean arterial pressure during the inflation period. At the end of surgery tourniquet was deflated. Tourniquet time was 76.83+/-16.94 minutes. After deflation of the tourniquet, heart rate & EtCO2 value increased & the values were maximum at 5 minutes. These values came down to the base line at 15 minutes. There was significant decrease of mean arterial pressure (MAP) at 5 minute; it also came to the base at 15 minute. These changes are usually benign but can be significant in patients with co-existing cardiovascular & intracranial diseases. In conclusion, we recommend the haemodynamic and End tidal CO2 monitoring as well as rapid fluid infusion along with hyperventilation for 15-30 minutes after deflation of tourniquet.

Sub arachnoid block for emergency cesarean section in a pituitary dwarf.

Anaesthesia for parturient patients with dwarfism is an uncommon problem faced by anaesthesiologists. There is an ongoing debate regarding general versus regional anaesthesia in these cases. In many centers there is lack of facilities for epidural or continuous epidural anaesthesia. A primiparous dwarf woman of 27 years old having 124 cm height and 37 kg weight was admitted in Mymensingh Medical College Hospital for elective cesarean section due to cephalopelvic disproportion. She was diagnosed as a case of pituitary dwarf previously on antenatal checkup depending on both clinical and endocrine ground. After admission she suddenly developed respiratory distress with less foetal movement and presented in our department for emergency cesarean section. We have managed the case by sub-arachnoid block (SAB) using 7.5 mg (1.5 ml) of 0.5% heavy bupivacaine at a level of L3-L4 interspace having adequate level of block and analgesia. The case was managed successfully and uneventfully. In this presentation, the role of SAB and a management guideline has been highlighted.

Serum zinc level in preterm low birth weight babies and its comparison between preterm AGA and preterm SGA babies.

Low birth weight (LBW) is a major child health problem in Bangladesh and continuing to great threat to child health and child survival in Bangladesh. LBW is a silent emergency but crisis is real and its persistence has profound and frightening impact on neonatal mortality. This observational study was conducted in Dhaka Shishu Hospital, Dhaka, Bangladesh during July 2004 to June 2005. Serum zinc levels were estimated between two groups: group-I preterm AGA (n=50), group II preterm SGA (n=50) babies. Blood samples were collected from the study population in neonatal unit and serum zinc levels were measured by flame atomic absorption spectrophotometry in Atomic Energy Center, Dhaka, Bangladesh. Observed data were made comparison among groups by Students 't' test. It was observed serum zinc level (60.2+/-15.2) in group I and (62.1+/-12.4) in group II. Serum zinc level was in lower limit of normal range in both groups with more lower level in preterm AGA babies but their difference was not statistically significant (p>0.05). So zinc supplementation may enhance the growth of preterm LBW babies in their early months of lives.

Spatial modulation in cross-linked binary polymer blends.

Spatial modulation means that the free energy of the composite mixture is minimized at a finite wavenumber, which defines the primary length scale, the maximum size possible, of the evolving phases. Although spatial modulation may appear in different systems in different ways and is not necessarily a thermodynamic precept, here it is expressed as a thermodynamic consequence of short-range interfacial forces pitted against long-range elastic forces. Cross-linked chains bring about new thermodynamic interactions based on their conformations and the fractal dimensions of the chain networks to which they tether and belong. Interplay among these different interactions during phase ordering brings about the spatial modulation and the spatial pattern. Here, the underlying processes are only succinctly outlined.