Comparative Efficacy and Safety of Amlodipine and Losartan Potassium in Essential Hypertension in a Tertiary Hospital of Bangladesh.

Hypertension is a common disorder of major clinical, public health and economic importance. It affects men and women of all ages, and the prevalence is increasing in most countries. Maintenance of blood pressure below 140/90 mm of Hg is recommended by most of the guideline available around the world. Various classes of drugs are being used in the treatment of hypertension. Losartan potassium and amlodipine are two different antihypertensive agents belonging to two different groups used commonly around the world in treating essential hypertension. Losartan potassium is non-peptide Angiotensin-II receptor antagonist. Amlodipine which is the third generation dihydropyridine group of calcium channel blocker. The aim of the study was to compare the efficacy and safety of amlodipine and losartan for the treatment of essential hypertensive patients (18-75 years). A non-randomized comparative observational study was conducted in the Department of Pharmacology and Therapeutics in collaboration with Department of Medicine, Sylhet, MAG Osmani Medical College, Sylhet, Bangladesh from July 2021 to June 2022. In this study non-randomization was in two groups. Group A received amlodipine 5mg daily at morning and Group B received losartan potassium 50mg daily at night. The study parameters were systolic blood pressure (SBP), diastolic blood pressure (DBP), ankle oedema, serum K+ level. The result of treatment outcome was compared between two groups. After treatment the reduction of SBP was 5.19±2.93mm of Hg versus 3.27±1.34mm of Hg (p<0.001); reduction of DBP was 1.7±0.70 mm of Hg versus 0.68 mm of Hg (p<0.001) and serum K+ level 4.22±0.27mmol/L versus 4.21±0.16mmol/L (p<0.719) in amlodipine and losartan group respectively. Amlodipine is more effective than losartan potassium in respect to treatment of essential hypertension. Regarding adverse events losartan potassium causes angioedema, hyperkalemia, headache, dizziness etc. The study concluded that amlodipine is superior to losartan potassium in treating essential hypertension.

Thyroid Hormone Level in Children with Nephrotic Syndrome.

Nephrotic syndrome is the most common glomerular disease affecting children. Hypothyroidism is one of the most important complications which occur due to urinary loss of protein bound thyroid hormones, such as thyroxin binding globulin, transthyretin and albumin. This cross sectional study was conducted in the Department of Pediatric, Mymensingh Medical College Hospital (MMCH), Bangladesh from February 2018 to October 2019. This study was carried out to find out the thyroid profile in children with nephrotic syndrome and compared with thyroid profile of other acute illness in children. Total 122 children aged 2-12 years, further subdivided into Group A (n=61) suffering from nephrotic syndrome (1st attack, infrequent relapse) and Group B (n=61) other disease like viral fever, pneumonia, bronchiolitis, diarrhoea, UTI. Demographic details of patients and their relevant clinical details were obtained by an interviewer administered questionnaire. Blood for free T4, TSH were taken and compared between both groups. The mean FT4 values in Group A and Group B were 16.09±22.32fmol/ml and 68.22±11.65fmol/ml respectively, whereas the TSH level was significantly higher in Group A than controls (5.42±1.04 vs. 3.53±1.44). The T4 levels in nephrotic syndrome (Group A) patients were low. Analysis was done by using SPSS 22.0 version for windows software. Continuous and catagorical parameters were compared by unpaired 't' test and Chi-Square test. A p-value of 0.05 was considered significant. Hypothyroidism was found more in younger children i.e. age less than 6 years. This study concluded that children with nephrotic syndrome have a state of hypothyroidism.

Medical Undergraduates' Assessment Status Regarding Clinical Neuroanatomy.

The study of Anatomy is essential to the learning of different subjects of medicine. Neuroanatomy is a fundamental part of the Anatomy portion of the undergraduate medical (MBBS) curriculum of different universities of Bangladesh. The clinical relevance of Neuroanatomy is beyond doubt in the context of increasing numbers of cases like stroke, head injury and meningitis in Bangladesh. Contemporary Neuroanatomy books are inclined to a clinically-oriented approach in their presentation. However, there is no organized attempt to analyze these recent trends of highlighting the significance of clinically-oriented approach reflected in the learning pattern or student-assessment in the medical undergraduate courses of Bangladesh. Such analyses can offer an insight into the situation and facilitate teachers and curriculum planners to make necessary modifications. The present study was planned- i) to analyze the Neuroanatomy portion of the recent undergraduate Anatomy written question papers of four public universities of Bangladesh for understanding how clinically relevant knowledge has been assessed in the questions ii) to determine the ability of the medical undergraduates to answer clinically-oriented written questions as compared to their ability to answer non-clinically-oriented questions in Neuroanatomy. It was a comparative study with some descriptive components. For Part-A of the study, all the 'Question-segment's of question (SAQ and MCQ) dealing with Neuroanatomy in all the available First Professional MBBS Exams' Anatomy written question papers of four public universities of Bangladesh of the last five years (2005 to 2009) were identified. The frequency of 'Question-segment's those assessing the ability of the clinically relevant knowledge were determined. It was a descriptive study. For Part-B of the study, total 136 New 3rd year medical undergraduates of one Bangladeshi governmental medical college and one private medical college were taken as participants. The medical undergraduates of each medical college were divided into two equal groups by randomization. One group was given 100 clinically-oriented questions and the other was given 100 non-clinically-oriented questions based on the content of Snell. The scores (frequencies of correct responses) of the two groups were compared using an unpaired 't' test. The frequencies of 'Question-segment's assessing clinically relevant knowledge was 6.14%. The performance of the undergraduates answering clinically-oriented questions was significantly poorer (p=0.01) than answering non-clinically-oriented questions (the mean score being 38.49±10.50 and 45.04±8.48 respectively). Teaching and assessment of Neuroanatomy should be designed in a way to orient medical undergraduates towards more clinically-oriented understanding and performance in Neuroanatomy. The clinically relevant knowledge dealing with Neuroanatomy needs to be addressed with appropriate weighting in the First Professional MBBS written questions of Bangladesh. Necessary changes in the curriculum are also suggested in meeting the above expectations.

Role of Rehabilitation Exercise on Myofascial Pain Syndrome Causing Upper Back Pain.

Upper back pain is as painful or troublesome as the pain in the lower back or the neck. Myofascial pain syndrome which is most common cause of upper back pain is characterized by localized musculoskeletal pain and tenderness in association with trigger points. The aim of the study was to correlate the improvement of myofascial pain syndrome patients with proper and timely physical therapy. This quasi experimental study was conducted in the department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh, from 1st January 2008 to 31st August 2008 to see the role of rehabilitation exercise on myofascial pain syndrome causing upper back pain. Sixty (60) patients of myofascial pain syndrome causing upper back pain were randomly assigned for treatment; out of which 23(38.33%) were male and 37(61.66%) were female. The male and female ratio was 1:1.6. The patients selected for the trial were divided into two groups: Group A and Group B. In group A (n=28) the patients were treated with thermotherapy- Microwave diathermy, non-steroidal anti inflammatory drugs and activities of daily living instructions and in Group B (n=32) with same interventions in addition to rehabilitation exercises. Treatment duration was 6 weeks. The difference of treatment improvement was statistically significant (p<0.05) from 1st week up to 6th week. After complete course of treatment 67.86% patients in Group A and 78.13% patients in group B reported improvement. So rehabilitation exercises can be a valuable adjunct to other modalities of treatment of myofascial pain syndrome causing upper back pain.

Knowledge, Attitude and Practice of Undergraduate Medical Students of Bangladesh Regarding COVID-19 and its Vaccination.

Medical students are one of the socially active, reliable, and persuading population of information, prevention and control, and incentive of vaccination to stop the current pandemic situation. Consequently, knowing the status of medical students' knowledge, about symptoms, and transmission of disease, prevention of COVID-19 and their attitudes towards a vaccine is important. This multi-center cross-sectional descriptive study was one of the first ones in Bangladesh among the undergraduate medical students who completed pathology, microbiology, and pharmacology. The study was conducted from March to April 2021, using a convenience sampling method in twelve government and non-government medical colleges. Among 1132 who completed the questionnaire, and 15 students from different centers were excluded from the pre-testing and face validation. The age of the 1117 respondents were 22 to 23 years, of which the majority of the respondents were female 749 (67.0%), and 368 (33.0%) were male. Almost all participants had correct knowledge (84.1%) about the symptoms of COVID-19. But 59.2% had wrong knowledge about transmission of disease by an afebrile person. Above 60.0 % of the participants have worn a facial mask when contacting people, refrained from shaking hands, washed hands, avoided people with signs and symptoms suggestive of COVID-19, and avoided crowded places as a practice of prevention. 37.6% of medical students showed positive attitudes about the participation of management of a COVID-19 patient. Most of the participants' decided to have a vaccine depending on its availability. But 31.5% had trust in natural immunity rather than vaccination. Most undergraduate Medical college students understood the basic information, possessed a positive attitude, and presented good practice towards the COVID-19 and vaccination. They play a crucial role in motivation and acceptance of vaccines among the general citizen to fight back against the pandemic in the country with limited resources.

Pattern of Initial Clinical Presentation of Systemic Lupus Erythematosus: A Hospital-Based Cross-Sectional Study from Bangladesh.

Systemic lupus erythematosus (SLE) is an autoimmune disorder involving multiple systems and often presents with diverse clinical manifestations. The objective of the present study was to investigate the initial clinical presentations of SLE patients attending a tertiary care hospital in Bangladesh. This cross-sectional study was conducted among 85 SLE patients diagnosed according to the 1997 ACR Revised Criteria for Classification of SLE attending the Lupus Clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2012 to June 2013. Sociodemographic and clinical data were collected from patient interviews, physical examinations and medical records. Almost 75.0% of the patients aged below 30 years had a female predominance (male-female ratio 1:5.6). Fever (71.0%), joint pain (60.0%) and alopecia (28.0%) were the most common initial presentations among the patients. Constitutional symptoms such as fatigue, malaise and weakness (23.5%), malar rash (21.0%), oral ulcer (20.0%), photosensitivity (15.0%) and Raynaud's phenomenon (13.0%) were also present in variable proportions. The musculoskeletal and mucocutaneous systems were most commonly affected (85.0% and 75.0% respectively), followed by lupus nephritis (40.0%), hematological symptoms (22.0%) and vasculitis (17.6%). Out of 85 patients, 78 (92.0%) tested positive for anti-nuclear antibodies. SLE patients commonly present with musculoskeletal and nonspecific symptoms at the initial phase. Hence, physicians should consider this clinical and immunological evidence along with conventional symptoms included in the ACR criteria.

Cooperative cargo transportation by a swarm of molecular machines.

Cooperation is a strategy that has been adopted by groups of organisms to execute complex tasks more efficiently than single entities. Cooperation increases the robustness and flexibility of the working groups and permits sharing of the workload among individuals. However, the utilization of this strategy in artificial systems at the molecular level, which could enable substantial advances in microrobotics and nanotechnology, remains highly challenging. Here, we demonstrate molecular transportation through the cooperative action of a large number of artificial molecular machines, photoresponsive DNA-conjugated microtubules driven by kinesin motor proteins. Mechanical communication via conjugated photoresponsive DNA enables these microtubules to organize into groups upon photoirradiation. The groups of transporters load and transport cargo, and cargo unloading is achieved by dissociating the groups into single microtubules. The group formation permits the loading and transport of cargoes with larger sizes and in larger numbers over long distances compared with single transporters. We also demonstrate that cargo can be collected at user-determined locations defined by ultraviolet light exposure. This work demonstrates cooperative task performance by molecular machines, which will help to construct molecular robots with advanced functionalities in the future.

A Rare Case of Polyorchidism: Sonographic and MR Evaluation of Four Testes.

Polyorchidism is a rare congenital anomaly reported about 200 cases in the world text. A number of theories have been planned concerning the making of polyorchidism, but the real explanation is still not acknowledged. Here we are going to present a case study of polyorchidism. A 70 years old gentleman complained with left supernumerary testes in the left hemiscrotum. His left hemiscrotum was painless with mass. Polyorchidism without malignancy or any other concomitant features were revealed by both ultrasound and MRI examinations. In most cases the ultrasonograph alone is diagnostic. In complicated cases of polyorchidism MRI may provide additional information.

Proportion of Low Back Pain among Physicians Working in a Tertiary Level Hospital of Bangladesh.

Low back pain (LBP) is a common problem and is an important public health issue. A major proportion of LBP is concomitant with prolong and repetitive awkward postures, related with occupation like miners, health workers and professional drivers. Physicians are exposed to a wide range of occupational risk factors which results in LBP. A variety of occupational and personal factors are responsible for increased risk of low back pain among physicians. This cross sectional descriptive study was carried out at Mymensingh Medical College Hospital during the period of January 2018 to June 2018, to estimate the proportion of LBP among physicians. Data were collected from purposively selected 102 physicians of different levels by face to face interview using a case record form. Informed written consent of participants was taken prior to interview. Data were analyzed by using SPSS version 20.0. The study results revealed that majority (60.8%) of the physicians were in the age group of 31-50 years. Mean age of the physicians was 49.9 years with a standard deviation (SD) of 3.61 years. More than three fourth (79, 77.5%) of the physicians were male and 23(22.5%) were female. Out of 102 physicians more than two third (70, 68.6%) had LBP while 32(31.4%) did not have any LBP. Proportion of low back pain among physician was 68.6%. Low back pain was found in all age group. Among the physicians having low back pain, 55(78.6%) were male and 15(21.4%) were female. Among 102 physicians, 45(44.1%) had different types of comorbidities while 57(55.9%) did not have any comorbidities. Among the co-morbidities HTN, DM, Dyslipidemia, CHD and asthma were common. Results of the study concluded that 68.6% physicians had low back pain. Physicians of age group 31-60 years (88.5%) and male (78.6%) experienced LBP more. Further multi-centric large scale case control study is recommended to determine the risk factors of LBP among physicians of Bangladesh.

Medical Undergraduates' Written Assessment Profile of Illustration-based Neuroanatomy.

Neuroanatomy is an integral part of Anatomy and it is one of the most visually dependent and visually-demanding one. Analysis of recent trends of emphasizing the importance of illustrations which are being reflected in the learning pattern or student-assessment can provide an insight into the situation and help teachers and curriculum planners. Thus, the present study was planned i) to analyze the Neuroanatomy portion of the recent undergraduate Anatomy written question papers of four public universities of Bangladesh for understanding how the ability to draw and label has been assessed in the questions and ii) to determine the ability of the undergraduate students to answer illustration-based questions as compared to their ability to answer non-illustration-based (text-based) questions in Neuroanatomy. For Part-A of the study, all the 'segment's of item (SAQ and MCQ) dealing with Neuroanatomy in all the available Anatomy written question papers of all the First Professional MBBS Exams of four public universities of Bangladesh of the last five years (2005 to 2009) were identified. The frequency of 'segment's those were assessing the ability to draw and label was determined. For Part-B of the study, 214 students were taken as participants. They were divided into two equal groups by randomization. The first group was given 100 illustration-based questions based on the illustrations representing different 'purpose's and 'form's in Snell1. The other group was given 100 non-illustration-based questions on the corresponding textual material. The scores of the two corresponding groups were compared using an unpaired 't' test. The frequency of segments was assessing the ability to draw and label was 3.86%. The performance of the undergraduates answering illustration-based questions was significantly poorer (p=0.0) than non-illustration-based questions (mean±SD being 23.36±14.02 and 44.75±9.50 respectively). Teaching and assessment of Neuroanatomy should be planned in a way to orient undergraduates towards more illustration-based understanding and performance. Necessary modifications in the curriculum are recommended.

Barriers to quality of work life among Bangladeshi nurses: a qualitative study.

AIM: To explore and provide understanding of the barriers to quality of work life among registered nurses in Bangladesh. BACKGROUND: Globally, there is growing interest in the working environments of nurses, especially at a time of nursing shortages and with the focus on safety and care quality in health systems. In a low socio-economic country like Bangladesh, nurses struggle in a grossly underfunded healthcare system to deliver care to the people but no studies have been conducted on their quality of work life. METHODS: This qualitative descriptive study was conducted at three Bangladeshi tertiary hospitals in May 2015-January 2016. Three focus group discussions were held with 30 registered nurses exploring their perceived barriers to quality of work life. Data were analysed with content analysis. FINDINGS: Seven barriers to their work-life arose: heavy workloads; lack of government accommodation and transportation; poor health status; lack of support from nursing supervisors; lack of promotion opportunities; incomplete hospital policies and procedures; and lack of night shift and risk allowances. DISCUSSION: Participants described many issues and barriers impacting on their work-life. They perceived little reward for their hard work, felt that their health suffered from their working conditions and described a low QWL. CONCLUSION AND POLICY IMPLICATIONS: Findings provide information for nursing and health policymakers and leaders to reduce barriers to improve work-life quality among nurses that can contribute better to quality of nursing care, and nursing retention and satisfaction. Work policies and practices, and funding and other resources need to be scrutinized to ensure better working conditions for Bangladeshi nurses. LIMITATIONS: Interviews were conducted with nurses only in tertiary hospitals in the Bangladeshi capital, and understanding of barriers to work-life quality of nurses in other health settings and regions needs to be explored.

Clinical Scoring Versus Chlamydia Antibody Titre as a Tool in Predicting Tubal Patency in Subfertile Women.

This study was done to compare the predictive capacity of Clinical scoring and Chlamydia antibody titre in predicting tubal patency. This cross sectional comparative study was done in Institute of Child and Mother Health, Dhaka, Bangladesh from January 2018 to December 2018. Eighty eight infertile women with normal ovarian reserve and their husbands with normal semen parameters were purposively included. After taking written informed consent, Clinical scoring, Chlamydia antibody titre and Hysterosalpingography of the study population were done. Data expressed as mean and standard deviation. Logistic regression analysis was done. The predictive capacity was analyzed by sensitivity, specificity, positive and negative predictive value and relative risk. Area under the Curve of Receiver Operating Characteristic was done. A p value <0.05 was considered as statistically significant. Fifty three and half percent had bilateral and 8% had unilateral tubal block and 38.5% had bilateral patent tubes. Clinical scoring versus Hysterosalphingography and Chlamydia antibody titre versus Hysterosalphingography of the study population had sensitivity 87.04% and 48.15%, specificity 76.47% and 58.82%, positive predictive value 82.95% and 52.27%, negative predictive value78.79% and 41.67% and relative risk 5.42 and 0.84 respectively. The Clinical Scoring is better than Chlamydia Antibody Titre as a tool in predicting tubal patency.

In vitro cytotoxicity and antibiotic application of green route surface modified ferromagnetic TiO2 nanoparticles.

The enormous numbers of applications of TiO2 nanoparticles (NPs) cause concern about their risk to the environment and human health. Consequently, motivated by the necessity of searching for new sources of TiO2 NPs of low cytotoxicity with antibacterial activity, we synthesized TiO2 NPs by a green route using a solution of titanium(iv) isopropoxide as a precursor and an aqueous extract of Artocarpus heterophyllus leaf as a reducing and surface modifying agent. We investigated their structure, shape, size, and magnetic properties, and evaluated their antibiotic application and cytotoxicity. The synthesized TiO2 NPs were applied against two Gram-negative bacteria (E. coli and S. typhimurium) and two Gram-positive bacteria (S. aureus and B. subtilis) to observe their antibacterial activity; and eventually clear zones of inhibition formed by the TiO2 NPs were obtained. Moreover, after exposing the synthesized TiO2 NPs to HeLa cells (carcinoma cells) and Vero cells (normal cells), no toxic effect was found up to a dose of 1000 mg L-1, indicating the safe use of the samples up to at least 1000 mg L-1. However, toxic effects on HeLa cells and Vero cells were observed at doses of 2000 mg L-1 and 3000 mg L-1, respectively. These results indicate the safe use of Artocarpus heterophyllus leaf extract mediated synthesized TiO2 NPs in their potential applications.

Vitamin D Status in Polycystic Ovarian Syndrome Patients Attending a Tertiary Hospital of Bangladesh.

Vitamin D deficiency is common in patients with polycystic ovarian syndrome (PCOS) and found to have multiple impacts on the disease process. Vitamin D status of women with or without PCOS in Bangladesh is largely unknown. This cross-sectional study was conducted in a tertiary level hospital of Bangladesh from January 2018 to April 2018 to address this lacuna. Sixty (60) newly diagnosed PCOS patients and 50 healthy controls aging ≥18 years were investigated for serum 25-hydroxy vitamin D [25(OH)D] level, fasting plasma glucose and fasting lipid profile in addition to their clinical and anthropometric profiles. None of the PCOS and the controls had sufficient 25(OH)D. Twenty five percent (25%) of PCOS patients were insufficient, 68.33% were deficient and 6.67% of were severely deficient of vitamin D; whereas in the control group the frequency was 12%, 50% and 38% respectively. PCOS patients had higher 25(OH)D than controls (17.53±4.6 vs. 13.79±6.1ng/mL, p<0.001). Although PCOS group had higher frequency of metabolic syndrome than control group (40% vs. 20%), 25(OH)D levels were similar in subjects with or without metabolic syndrome in both PCOS (16.82±4.74 vs. 17.99±4.49ng/mL, mean±SD, p=0.098) and control groups (14.06±5.94 vs. 13.73±6.20ng/mL, mean±SD, p=0.339). 25(OH)D level correlated with none of the clinical, anthropometric, metabolic and hormonal parameters in PCOS patients. Vitamin D deficiency is highly prevalent in Bangladeshi PCOS patients and healthy women of reproductive age.

The challenges of prenatal care for Bangladeshi women: a qualitative study.

BACKGROUND: Maternal and infant morbidity and mortality are major issues in developing countries, but the literature reveals there are limited studies on the sociocultural issues affecting adequate prenatal care in Bangladesh. AIM: To explore the sociocultural influences underlying perceived barriers to prenatal care among pregnant women in an urban area of Bangladesh. METHODS: A descriptive qualitative research was conducted with 20 women and 20 of their significant others in three purposively sampled hospitals using individual in-depth interview between November 2016 and March 2017. Content analysis was used for analysis. FINDINGS: Six themes emerged as follows: women's lack of opportunity to make decision; pregnancy as a normal life event; insufficient money for prenatal care; heavy family workload without family support; no permission to go to hospital without a guardian; and inconvenient transportation. DISCUSSION: Good prenatal care is vital for maternal and infant health, but our participants were challenged by a number of key issues as follows: they lacked empowerment to make their own pregnancy decisions, they were impoverished financially, struggled to get to their prenatal appointments by local transport and they lacked family understanding and support for necessary prenatal care. CONCLUSION AND POLICY IMPLICATIONS: Based on the findings, it is recommended that promoting prenatal care adequacy among pregnant women in Bangladesh needs socioculturally sensitive health education programmes which target are not only pregnant women, but also their significant others who are authorized persons in the family. It should be established remote PNC services. Empowerment of women is vital in the country and free antenatal education programmes are needed through a variety of media. Findings provide information for nursing and health policymakers to develop policies to improve adequacy of prenatal care among pregnant women.

Analyses of the Neuroanatomy Portion of the Anatomy Question Papers for Written Summative Assessment at the Medical Undergraduate Level in Bangladesh.

Neuroanatomy is a vital part of the undergraduate medical (MBBS) Anatomy curriculum of different universities of Bangladesh. The teaching-learning and assessment of Neuroanatomy have gone through significant changes in current times in various parts of the world. Neuroanatomy textbooks are supposed to be useful reflectors of these changes and of the present inclinations. The importance of an understanding approach towards Neuroanatomy is beyond doubt. Consequently, the contemporary Neuroanatomy books are inclined more towards an understanding approach in their presentation. However, there has been no organized effort in analysing how such trends are being reflected in the student-assessment in the medical undergraduate courses of Bangladesh. This kind of study can provide useful insight into the present circumstances and assist teachers and curriculum planners in formulating crucial changes. The present study was aimed at analysing the Neuroanatomy written questions of five years' First Professional MBBS Exams regarding content coverage and level of cognitive domain addressed. The study was a descriptive observational one involving qualitative analyses (and quantitation) of questions. All the 'segment's of every item (SAQ and MCQ) dealing with Neuroanatomy in all the available Anatomy written question papers of all the First Professional MBBS Exams of four public universities of Bangladesh of five years (2005 to 2009) were analysed. The frequencies of item- 'segment's dealing with different chapters (or similar parts) of a Neuroanatomy textbook commonly recommended to the medical undergraduate course of the country1 were estimated to determine the content coverage and the item- 'segment's addressing different levels of cognitive domain were identified. The relative coverage of different chapters (or similar parts) of the textbook by Snell1 in the question papers showed considerable differences from the relative proportions of the corresponding chapters (or similar parts) in the book itself. Most (97.64%) of the item-'segment's addressed the recall-level of cognitive domain. The understanding-level was addressed by only 2.36% of 'segment's, but no application-level 'segment' could be identified. The findings of the present research assist teachers, paper- setters and moderators of questions as well as the curriculum planners in integrating the current trends in Neuroanatomy in the respective domains so that pre-clinical undergraduates can be made better prepared for the upcoming years and occupation.

Cdc14 Phosphatase Promotes TORC1-Regulated Autophagy in Yeast.

Cdc14 protein phosphatase is critical for late mitosis progression in budding yeast, although its orthologs in other organisms, including mammalian cells, function as stress-responsive phosphatases. We found herein unexpected roles of Cdc14 in autophagy induction after nutrient starvation and target of rapamycin complex 1 (TORC1) kinase inactivation. TORC1 kinase phosphorylates Atg13 to repress autophagy under nutrient-rich conditions, but if TORC1 becomes inactive upon nutrient starvation or rapamycin treatment, Atg13 is rapidly dephosphorylated and autophagy is induced. Cdc14 phosphatase was required for optimal Atg13 dephosphorylation, pre-autophagosomal structure formation, and autophagy induction after TORC1 inactivation. In addition, Cdc14 was required for sufficient induction of ATG8 and ATG13 expression. Moreover, Cdc14 activation provoked autophagy even under normal conditions. This study identified a novel role of Cdc14 as the stress-responsive phosphatase for autophagy induction in budding yeast.

Abandonment and Outcome of Childhood Acute Myeloid Leukemia in A Tertiary Level Hospital.

Acute leukemias are the most common child hood malignancy, of which acute myeloid leukemia (AML) are 15 to 20%. Abandonment is one of the most important causes of treatment failure in AML in developing countries. Lost to follow-up is also a big problem in low income countries. Many patients stop therapy soon after diagnosis due to cost, distance and ignorance. To determine the abandonment, outcome and treatment related mortality (TRM) and morbidity among children with AML. This prospective observational study was conducted in the Department of Pediatric hematology and Oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from February 2013 to January 2014. Fifty (50) patients of AML visited to out patient department (OPD) of Pediatric hematology and Oncology. Among them 11(22%) patients refuse treatment from outdoor. Thirty nine (78%) patients of AML were selected as per inclusion and exclusion criteria. After proper evaluation and clinical examination of these patients, CBC and Bone marrow examination was done for confirmation of diagnosis. A total of 39 patients were recruited in this study. Seventeen (43.6%) patients were male and 22(56.4%) were female. Mean±SD of age was 7.80±4.42 years and range was 1 year to 18 years. Out of 39 patients, 18(46.1%) patients were abandoned, 15(38.4%) expire, relapse 2(5.2%) & alive 4(10.3%). High abandonment (46.1%) and treatment related toxic death (38.4%) has compromised the outcome of acute myeloid leukemia. However AML can be treated with better outcome if improved the supportive care, reduce toxic death, refusal or abandonment.

Green synthesis of bio-molecule encapsulated magnetic silver nanoparticles and their antibacterial activity.

Persuaded by the necessity of finding new sources of antibiotics, silver nanoparticles (Ag NPs) were synthesized by adopting a newly developed green synthesis technique and subsequently, their antibacterial activity against different pathogenic bacteria was evaluated. We have successfully synthesized bio-molecule capped ferromagnetic Ag NPs with an average crystallite size of 13 nm using AgNO3 solution as a precursor and Artocarpus heterophyllus leaf extract as a reducing and capping agent. The characterization of the synthesized Ag NPs was carried out using various techniques such as UV-visible (UV-Vis) spectroscopy, energy dispersive X-ray (EDX) spectroscopy, Fourier transform infrared (FT-IR) spectroscopy, field emission scanning electron microscopy (FESEM), transmission electron microscopy (TEM), thermogravimetry (TG), and vibrating sample magnetometer (VSM) analyses. After exposing the synthesized Ag NPs to two Gram-positive bacteria - Staphylococcus aureus and Bacillus cereus and two Gram-negative bacteria - Escherichia coli and Salmonella typhimurium, the zones of inhibition were found to be 15, 16, 19, and 18 mm, respectively. These results imply that the Artocarpus heterophyllus leaf extract mediated green synthesized bio-molecules encapsulated Ag NPs can be considered as a potential antibiotic against human pathogens which is very encouraging.

Effects of Intensive versus Non-Intensive Physical Therapy on Children with Cerebral Palsy.

Cerebral Palsy (CP) is one of the most common causes of all childhood disorders. There are tone, posture and movements difficulty due to non-progressive damage to the immature brain in CP. The hallmark of CP is a disability in the development of gross motor function (GMF). The influence of gross motor development on fine motor development is more important in early developmental period, specially under three years old and in children with CP. Various therapeutic interventions have been used in the management of GMF development. Among them physical therapy is the most common intervention in CP and is usually a component of mandated programs. Physical therapy means physical stimulations in the form of various therapeutic exercises, touch, massage, limbs and trunk movement, balancing and coordination training, gait and ambulation training, cognitive stimulation as well as speech, language and occupational therapy. Our study focused to see the effect by short term intensive versus non-intensive physical therapy on children GMF development by using gross motor function measure (GMFM) Score sheet, GMFM-88, version 1.0. Study provides the information that physical therapy intervention is effective in GMF development and intensive interventions are more effective in children with spastic CP than non-intensive one. Study also inform that the more early treatment the more effective result.