Risk Association, Clinical Presentation and Management of Uterine Leiomyoma.

Uterine leiomyoma is a common gynecological problem throughout the world. As 50% hysterectomies in black and 40% in Australians are performed due to fibroid, in our country also it is assumed that about 40%-50% hysterectomies are done due to fibroid uterus. Thus leiomyoma constitute a major public health cost to the community in terms of outpatient attendance and hospital cost for surgery. This is a descriptive type of cross sectional study among 50 patients having leiomyoma of uterus in the department of Obs and Gynae, BSMMU hospital from March 2011 to August 2011. The objective of the study is to find out the risk associated with leiomyoma, to find out the common presenting features of uterine leiomyoma and to find out best options for management. Study results showed that 62% patients were in the age group 36-45 years, 48%patients were in para1-2 group, 32% patients used combined oral contraceptive pill for contraception. Sixty percent (60%) patients presented with progressive menorrhagia and palpable mass was found in 62% cases. About 46% patients had associated medical conditions like hypertension, diabetes, obesity. Total abdominal hysterectomy was done in 32% cases. TAH with unilateral or bilateral salpingoophorectomy was done in 40% cases. Myomectomy was done in 20% cases. There is a scope for large scale study about risk factors of uterine leiomyoma like obesity, diabetes mellitus, hypertension, use of hormonal contraceptive, racial differences, different treatment modalities etc. Treatment should be individualized. However in this connection a good referral system and good communication has got a tremendous contribution in the proper management of such problems.

Obstetric Outcome of Multiple Pregnancy in a Medical College Hospital.

The Incidence of twin and high order multiple gestation has increased significantly over the past 15 years primarily because of the availability and increased use of ovulation inducing drugs and assisted reproductive technology. Both maternal and perinatal mortality and morbidity is higher in multiple pregnancy than in singleton pregnancy. Proposed study is designed to determine the incidence and obstetric outcome of multiple pregnancy which is a high-risk pregnancy in a tertiary referral hospital. The purpose of this study is to evaluate obstetric outcome of multiple pregnancy. This prospective observational study was carried out in the Department of Obs and Gynae, Mymensingh Medical College Hospital, Mymensingh from December 2011 to May 2012. Patients were selected by purposive way. In this study it was observed that incidence of twin pregnancy was 1.66% common age group 30-35 years (48%), common in multipara (74%), no pregnancy crossed EDD. Family history of twin was 32% and unknown etiology 58%. Most common maternal complication was preterm labour (60%). Commonest mode of delivery was LSCS (64%), incidence of perinatal mortality 15%, 36% baby had birth weight in between 2.1-2.5kg, all the baby requiring admission in neonatal unit. This prospective observational study revealed that perinatal mortality was high in our center, there was no maternal mortality.

A Comparative Study Between 20% Mannitol and 3% Hypertonic Saline for Brain Oedema Reduction during Elective Brain Tumour Surgery.

Cerebral oedema is an important manifestation of brain tumour. The significant reduction of cerebral oedema can show rapid improvement of the patients. Hypertonic saline solution and mannitol both are commonly used for this action. It is now time to choose the better one. This was a prospective randomized comparative study designed to evaluate the efficacy of 3% hypertonic saline (NaCl) in reduction of brain oedema during brain tumour surgery and compare it with that of 20% Mannitol. The study was conducted in the department of Anaesthesiology, Combined Military Hospital, Dhaka, Bangladesh from July 2016 to December 2016. A total number of 47 patients for brain tumour surgery were selected. After screening 40 patients were finalized. Then the patients were divided into 2 equal groups 20 patients in each. Patients of Group A received 3% hypertonic saline and Group B 20% mannitol. Uniform anaesthetic technique applied for all patients, fixed surgeon/group of surgeons carried out the surgery. Heart rate and noninvasive blood pressure were monitored and kept with in ±20% baseline values different means. ETCO2 were kept in between 28-32mm of Hg by adjusting ventilator setting. Reduction of brain oedema was monitored by subjective assessment of surgeons using a 3 point scale of brain relaxation. The data were recorded in preformed data sheet. The results were tested by chi-square test to see their level of significance i.e. p value <0.05 was considered as significant. At the opening of dura, the number of brain conditions classified as soft, adequate and tight were statistically non-significant between groups. After 0.5 hour and 1.0 hour 10% patient's brain was tight in Group A whereas it was 35% and 40% in Group B respectively. Reduction of brain oedema or brain relaxation was significantly better in Group A compared to Group B (p<0.05). Urine output was higher with mannitol than hypertonic saline (p<0.05). Duration of ICU and hospital stay in both Group A and Group B were statistically similar (p>0.05). Compared to mannitol, hypertonic saline caused an increase in serum sodium concentration over time (p<0.05). From the available data, use of 20% mannitol and 3% hypertonic saline for brain oedema reduction, it is suggested that hypertonic saline significantly reduces the risk of tight brain and produce the brain more soft than mannitol during brain tumour surgery.

Effect of confinement potential shape on the electronic, thermodynamic, magnetic and transport properties of a GaAs quantum dot at finite temperature.

The effect of the shape of the confinement potential on the electronic, thermodynamic, magnetic and transport properties of a GaAs quantum dot is studied using the power-exponential potential model with steepness parameter p. The average energy, heat capacity, magnetic susceptibility and persistent current are calculated using the canonical ensemble approach at low temperature. It is shown that for soft confinement, the average energy depends strongly on p while it is almost independent of p for hard confinement. The heat capacity is found to be independent of the shape and depth of the confinement potential at low temperatures and for the magnetic field considered. It is shown that the system undergoes a paramagnetic-diamagnetic transition at a critical value of the magnetic field. It is furthermore shown that for low values of the potential depth, the system is always diamagnetic irrespective of the shape of the potential if the magnetic field exceeds a certain value. For a range of the magnetic field, there exists a window of p values in which a re-entrant behavior into the diamagnetic phase can occur. Finally, it is shown that the persistent current in the present quantum dot is diamagnetic in nature and its magnitude increases with the depth of the dot potential but is independent of p for the parameters considered.

Serotonergic mechanisms in the 6-Hz psychomotor seizures in mice.

Serotonin (5-hydroxytrytamine (5-HT)) plays an important role in experimental seizures. Recently, we reported the depletion of 5-HT by parachlorophynylalanine (PCPA) in whole brain to enhance 6-Hz psychomotor seizures in mice. In the present work, we investigated the effect of 5-HT depletion in cortex and hippocampus, brain regions relevant for epilepsy, on behavioral and ultra-structural changes following 6-Hz psychomotor seizures in mice. In addition, we studied the effect of sodium valproate (SVP) on behavioral, biochemical, and ultra-structural effects induced by 6 Hz. Behavioral changes induced by 6 Hz stimulation were characterized as the increased duration of Straub's tail, stun position, twitching of vibrissae, forelimb clonus, and increased rearing and grooming. PCPA administration further enhanced while SVP reduced these behaviors in mice. The 6-Hz psychomotor seizure induced ultra-structural changes in both cortex and hippocampus in mice treated with PCPA. Furthermore, PCPA administrations followed by 6Hz-induced seizures were accompanied by reduced hippocampal and cortical 5-HT. SVP attenuated the PCPA-induced ultra-structural changes and alterations of 5-HT content in the mouse brain. The study suggests the involvement of 5-HT in the 6 Hz psychomotor seizures and in the mechanisms of action of SVP against such seizures in mice.

Cell-Permeable Bicyclic Peptidyl Inhibitors against NEMO-IκB Kinase Interaction Directly from a Combinatorial Library.

Macrocyclic peptides are capable of binding to flat protein surfaces such as the interfaces of protein-protein interactions with antibody-like affinity and specificity, but generally lack cell permeability in order to access intracellular targets. In this work, we designed and synthesized a large combinatorial library of cell-permeable bicyclic peptides, in which the first ring consisted of randomized peptide sequences for potential binding to a target of interest, while the second ring featured a family of different cell-penetrating motifs, for both cell penetration and target binding. The library was screened against the IκB kinase α/ß (IKKα/ß)-binding domain of NF-κB essential modulator (NEMO), resulting in the discovery of several cell-permeable bicyclic peptides, which inhibited the NEMO-IKKß interaction with low µM IC50 values. Further optimization of one of the hits led to a relatively potent and cell-permeable NEMO inhibitor (IC50 = 1.0 µM), which selectively inhibited canonical NF-κB signaling in mammalian cells and the proliferation of cisplatin-resistant ovarian cancer cells. The inhibitor provides a useful tool for investigating the biological functions of NEMO/NF-κB and a potential lead for further development of a novel class of anti-inflammatory and anticancer drugs.

Magnetic field effect on the energy levels of an exciton in a GaAs quantum dot: Application for excitonic lasers.

The problem of an exciton trapped in a Gaussian quantum dot (QD) of GaAs is studied in both two and three dimensions in the presence of an external magnetic field using the Ritz variational method, the 1/N expansion method and the shifted 1/N expansion method. The ground state energy and the binding energy of the exciton are obtained as a function of the quantum dot size, confinement strength and the magnetic field and compared with those available in the literature. While the variational method gives the upper bound to the ground state energy, the 1/N expansion method gives the lower bound. The results obtained from the shifted 1/N expansion method are shown to match very well with those obtained from the exact diagonalization technique. The variation of the exciton size and the oscillator strength of the exciton are also studied as a function of the size of the quantum dot. The excited states of the exciton are computed using the shifted 1/N expansion method and it is suggested that a given number of stable excitonic bound states can be realized in a quantum dot by tuning the quantum dot parameters. This can open up the possibility of having quantum dot lasers using excitonic states.

Composite biopolymers for bone regeneration enhancement in bony defects.

For the past century, various biomaterials have been used in the treatment of bone defects and fractures. Their role as potential substitutes for human bone grafts increases as donors become scarce. Metals, ceramics and polymers are all materials that confer different advantages to bone scaffold development. For instance, biocompatibility is a highly desirable property for which naturally-derived polymers are renowned. While generally applied separately, the use of biomaterials, in particular natural polymers, is likely to change, as biomaterial research moves towards mixing different types of materials in order to maximize their individual strengths. This review focuses on osteoconductive biocomposite scaffolds which are constructed around natural polymers and their performance at the in vitro/in vivo stages and in clinical trials.

The Effect of Subchronic Dosing of Ciproxifan and Clobenpropit on Dopamine and Histamine Levels in Rats.

The present study was designed to investigate the effect of once daily for 7-day (subchronic treatment) dosing of histamine H3 receptor antagonists, ciproxifan (CPX) (3 mg/kg, i.p.), and clobenpropit (CBP) (15 mg/kg, i.p), including clozapine (CLZ) (3.0 mg/kg, i.p.) and chlorpromazine (CPZ) (3.0 mg/kg, i.p.), the atypical and typical antipsychotic, respectively, on MK-801(0.2 mg/kg, i.p.)-induced locomotor activity, and dopamine and histamine levels in rats. Dopamine and histamine levels were measured in striatum and hypothalamus, respectively, of rat brain. Atypical and typical antipsychotics were used to serve as clinically relevant reference agents to compare the effects of the H3 receptor antagonists. MK-801-induced increase of horizontal activity was reduced with CPX and CBP. The attenuation of MK-801-induced locomotor hyperactivity produced by CPX and CBP was comparable to CLZ and CPZ. MK-801 raised dopamine levels in the striatum, which was reduced in rats pretreated with CPX and CBP. CPZ also lowered striatal dopamine levels, though the decrease was less robust compared to CLZ, CPX and CBP. MK-801 increased histamine content although to a lesser degree. Subchronic treatment with CPX and CBP exhibited further increase in histamine levels in the hypothalamus compared to the MK-801 treatment alone. Histamine H3 receptor agonist, R-α methylhistamine (10 mg/kg, i.p.) counteracted the effects of CPX and CBP. In conclusion, the subchronic dosing of CPX/CBP suggests some antipsychotic-like activities as CPX/CBP counteracts the modulatory effects of MK-801 on dopamine and histamine levels and prevents MK-801-induced hyperlocomotor behaviors.

Primary prevention with statins in cardiovascular diseases: A Saudi Arabian perspective.

Cardiovascular disease (CVD) constitutes one of the major causes of deaths and disabilities, globally claiming 17.3 million lives a year. Incidence of CVD is expected to rise to 25 million by 2030, and Saudi Arabia, already witnessing a rapid rise in CVDs, is no exception. Statins are the drugs of choice in established CVDs. In the recent past, evidence was increasingly suggesting benefits in primary prevention. But over the last decade Saudi Arabia has a witnessed significant rise in CVD-related deaths. Smoking, high-fat, low-fiber dietary intake, lack of exercise, sedentary life, high blood cholesterol and glucose levels were reported as frequent CVD-risk factors among Saudis, who may therefore be considered for primary prevention with statin. The prevalence of dyslipidemia, in particular, indicates that treatment should be directed at reducing the disorder with lipid-modifying agents and therapeutic lifestyle changes. The recent American College of Cardiology (ACC)/American Heart Association (AHA) guidelines has reported lowering the low-density lipoprotein cholesterol (LDL-C) target levels, prescribed by the 2011 European Society of Cardiology (ESC)/the European Atherosclerosis Society (EAS). The new ACC/AHA guidelines have overemphasized the use of statin while ignoring lipid targets, and have recommended primary prevention with moderate-intensity statin to individuals with diabetes aged 40-75 years and with LDL-C 70-189 mg/dL. Treatment with statin was based on estimated 10-year atherosclerotic-CVD (ASCVD) risk in individuals aged 40-75 years with LDL-C 70 to 189 mg/dL and without clinical ASCVD or diabetes. Adoption of the recent ACC/AHA guidelines will lead to inclusion of a large population for primary prevention with statins, and would cause over treatment to some who actually would not need statin therapy but instead should have been recommended lifestyle modifications. Furthermore, adoption of this guideline may potentially increase the incidences of statin intolerance and side-effects. On the other hand, the most widely used lipid management guideline, the 2011 ESC/EAC guidelines, targets lipid levels at different stages of disease activity before recommending statins. Hence, the 2011 ESC/EAC still offers a holistic and pragmatic approach to treating lipid abnormalities in CVD. Therefore, it is the 2011 ESC/EAC guidelines, and not the recent ACC/AHA guidelines, that should be adopted to draw guidance on primary prevention of CVD in Saudi Arabia.

An assessment following root canal preparation by Er,Cr: YSGG laser irradiation in straight and curved roots, in vitro.

In the present study, the effectiveness of Er,Cr:YSGG laser in straight and curved root canal preparation was compared with that of the conventional canal preparation technique, in vitro. The degree of root curvature of 40 root canals was determined, and then 20 canals were prepared by an Er,Cr:YSGG laser of 2 W by using the crown-down technique, while the other 20 canals were shaped by K-file (control). The achievement degree of root canal preparation and debris score was investigated morphologically. The results indicated that straight root canals could be successfully prepared by Er,Cr:YSGG laser irradiation; a significant decrease of smear layer or debris was also recognized (P<0.01). However, canal preparation by laser device in curve root often leads to a ledge or zipped formation, perforation or over-instrumentation. The results demonstrated that further development in laser device and technique are required to ensure its success in root canal preparation, especially in curve root.

Chemometric modeling to relate antioxidants, neutral lipid fatty acids, and flavor components in chicken breasts.

Relationships among quality factors in retailed free-range, corn-fed, organic, and conventional chicken breasts (9) were modeled using chemometric approaches. Use of principal component analysis (PCA) to neutral lipid composition data explained the majority (93%) of variability (variance) in fatty acid contents in 2 significant multivariate factors. PCA explained 88 and 75% variance in 3 factors for, respectively, flame ionization detection (FID) and nitrogen phosphorus (NPD) components in chromatographic flavor data from cooked chicken after simultaneous distillation extraction. Relationships to tissue antioxidant contents were modeled. Partial least square regression (PLS2), interrelating total data matrices, provided no useful models. By using single antioxidants as Y variables in PLS (1), good models (r2 values > 0.9) were obtained for alpha-tocopherol, glutathione, catalase, glutathione peroxidase, and reductase and FID flavor components and among the variables total mono and polyunsaturated fatty acids and subsets of FID, and saturated fatty acid and NPD components. Alpha-tocopherol had a modest (r2 = 0.63) relationship with neutral lipid n-3 fatty acid content. Such factors thus relate to flavor development and quality in chicken breast meat.

Environmental education for all engineers.

Environmental engineering education at universities is a rapidly changing field globally. Traditionally it has resided in the civil engineering program addressing water and wastewater quality, treatment, design and regulatory issues. In recent years environmental engineering has become a much broader field encompassing water, wastewater, soil pollution, air pollution, risk assessment, ecosystems, human health, toxicology, sustainable development, regulatory aspects and much more. The need to introduce environmental engineering/green engineering/pollution prevention/design for the environment concepts to undergraduate engineering students has become recognized to be increasingly important. This need is being driven in part through the US Engineering Accreditation Commission Accreditation Board for Engineering and Technology criteria 2000. Thus there has been a major shift in environmental engineering education and it no longer resides only within the civil engineering discipline. This paper focuses on the development of innovative curricula for a brand new engineering program at Rowan University that integrates environmental education for all engineers. A common course known as "engineering clinic" was developed for all engineering students throughout their eight semesters of engineering education. One of the clinic goals is to integrate engineering design and the environment. The program, in its seventh year, indicates successful implementation of environmental education in all four engineering disciplines in their course work and clinics.

Studies on neurolathyrism.

Neurolathyrism is a neurological condition seen among people who eat the seeds of Lathyrus sativus (LS) as a principal source of food energy for 2 months or more. It is characterized by severe muscular rigidity and paralysis of the lower limbs. beta-N-Oxalyl-L-alpha,beta-diaminopropionic acid is the principal toxin found in the seed. No experimental animal model for neurolathyrism could be produced by feeding either the seeds or the toxin, although the condition has been known for centuries. We discovered that experimental neurolathyrism could be produced in guinea pigs and primates that needed an external supply of ascorbic acid by making them subclinically deficient in ascorbic acid and feeding them the seeds of LS or extracts thereof. Autoclaving the seeds of LS with lime removes the toxin.

Effect of ascorbic acid in the treatment of tetanus.

The effect of daily intravenous administration of 1000 mg ascorbic acid (AA) in tetanus patients aged 1-30 years was studied. In the age group of 1-12 years, 31 patients were treated with AA as additional to antitetanus serum, sedatives and antibiotics. It was found that none of the patients died who received AA along with the conventional antitetanus therapy. On the other hand, 74.2 per cent of the tetanus patients who received the conventional antitetanus therapy without AA (control group) were succumbed to the infection. In the other age group of 13-30 years, there were 27 and 38 patients in the treatment and control groups respectively. The mortality in the AA and control groups were 37 percent and 67.8 percent respectively. These results suggest that AA might play an important role in reducing the mortality of tetanus. This was supported by the fact that AA was found to mitigate the toxic effects of strychnine producing tetanus like condition in young chicks in the present study.