Clinical Profiles and Outcomes of Cytomegalovirus Positive Renal Transplant Patients in Early Post-Transplant Period.

Cytomegalovirus infection can cause increased mortality and morbidity in renal transplant recipient. The purpose of the present study was to observe the clinical profiles and outcomes of Cytomegalovirus positive renal transplant patients in early post-transplant period. This prospective cohort study was conducted in the Department of Nephrology at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from September 2016 to August 2017. Adult patients who had undergone renal transplantation were selected as study population. CMV serology (CMV IgM and CMV IgG) of both donor and recipient were detected before renal transplantation. Cytomegalovirus viral DNA was extracted from both serum by using a commercially available DNA extraction kit and PCR was done by the StepOne™ PCR machine using real time PCR kit in all patient during the early post-transplant period. During this period, sign symptoms of patients with cytomegalovirus infection as well as clinical outcomes were also noted. Total number of 32 patients was included in this study with the mean age of 31.15±11.56 years. Cytomegalovirus was found positive in 11(34.4%) patients and negative in 21(65.6%) patients. Anorexia was the most common presentation which was found in 81.8% cases followed by renal impairment, fever, diarrhea, cough and weight loss which were present in 6(54.5%), 3(27.3%), 2(18.2%), 2(18.2%) and 2(18.2%) cases respectively. The outcomes of cytomegalovirus positive patients in first 6 months after renal transplantation revealed 25.0% patients had cytomegalovirus infection; 6.2% patients had cytomegalovirus disease and 6.2% patients were died. However, 9.4% patients had co-infection in the form of UTI and 6.2% patients had re activation of hepatitis C infection associated with cytomegalovirus infection. Cytomegalovirus was found positive in approximately one third of renal transplant recipients in early post-transplant period. Careful clinical evaluation and appropriate laboratory parameters should be looked over for timely diagnosis and management of these cases.

Discovery of a new nucleotide substitution in the MC1R gene and haplotype distribution in native and non-Japanese chicken breeds.

Melanocortin 1-receptor (MC1R) is one of the major genes that controls chicken plumage colour. In this study, we investigated the sequence and haplotype distribution of the MC1R gene in native Japanese chickens, along with non-Japanese chicken breeds. In total, 732 and 155 chickens from 30 Japanese and eight non-Japanese breeds respectively were used. Three synonymous and 11 non-synonymous nucleotide substitutions were detected, resulting in 15 haplotypes (H0-H14). Of these, three were newly found haplotypes (H9, H13 and H14), of which one (H9) was composed of known substitutions C69T, T212C, G274A and G636A. The second one (H13) possessed newly found non-synonymous substitution C919G, apart from the known substitutions C69T, G178A, G274A, G636A and T637C. The third one (H14) comprised a newly discovered substitution C919G in addition to the known C69T, G274A and G409A substitutions. The homozygote for this new haplotype exhibited wt like plumage despite the presence of G274A. In addition to discovering a new nucleotide substitution (C919G) and three new haplotypes, we defined the plumage colour of the bird that was homozygous for the A644C substitution (H5 haplotype) as wheaten-like for the first time; although the substitution has been already reported, its effect was not revealed. Besides detecting the new plumage colour, we also confirmed that the A427G and G274A substitutions contribute in expressing brownish and black plumage colour respectively, as reported by the previous studies. Moreover, we confirmed that the buttercup allele does not express black plumage despite possessing a G274A substitution, under the suppression effect of A644C. In contrast, the birds homozygous for the birchen allele presented solid black plumage, which was contradictory to the previous reports. In conclusion, we revealed a large diversity in the MC1R gene of native Japanese chicken breeds, along with the discovery of a new non-synonymous nucleotide substitution (C919G) and three novel haplotypes (H9, H13 and H14).

Spreading Waves in a Farmers and Hunter-Gatherers Model of the Neolithic Transition in Europe.

The Neolithic transition began the spread of early agriculture throughout Europe through interactions between farmers and hunter-gatherers about 10,000 years ago. Archeological evidence produced by radiocarbon dating indicates that the expanding velocity of farming is roughly constant all over Europe. Theoretical understanding of such evidence has been performed from mathematical modeling viewpoint. However, the expanding velocity determined by existing modeling approaches is faster than the observed velocity. For understanding this difference, we propose a three-component reaction-diffusion system which consists of two different types of farmers (sedentary and migratory) and hunter-gatherers from the viewpoint of the influence of farming technology. Our purpose is to study the relation between the expanding velocity of farmers and the farming technology parameter (say, [Formula: see text]). In this paper, we mainly focus on the one-dimensional traveling wave solution with minimal velocity and show that the minimal velocity decreases, as [Formula: see text] increases. This can be compatible with the observed velocity when farming technology is developed. Our results suggest that the reason for the slowdown of the Neolithic transition might be related to the increase in the development of farming technology.

Distal Common Bile Duct Tuberculosis with Obstructive Jaundice: A Case Report.

Tuberculosis (TB) isolated in Common Bile Duct (CBD) is very rare and its treatment is somewhat controversial. We report a case of distal CBD tuberculosis diagnosed as cholangiocarcinoma. A 40 year old man presented with obstructive jaundice without abdominal pain, fever or weight loss. Ultrasonography and Magnetic Resonance Cholangio-Pancreatography (MRCP) indicated a mass lesion in the Distal CBD, which caused structure of the distal common bile duct. As Cholangiocarcinoma was suspected, he underwent Whipple procedure (pancreaticoduodenectomy). Histological examination of resected specimen revealed typical features of tuberculosis in the distal CBD, pancreatic head and lymph nodes. The rest of the abdominal cavity was unremarkable. Anti-microbial therapy for tuberculosis is started for 12 month course and he is well.

Frequent acquisition of low-virulence strains of ESBL-producing Escherichia coli in travellers.

OBJECTIVES: International travel is a risk factor for intestinal colonization with ESBL-producing Enterobacteriaceae (EPE). This prospective cohort study focuses on molecular features of and risk factors for travel-acquired EPE. METHODS: Rectal swabs and survey data were collected from 188 Swedes travelling to four regions of high EPE prevalence. Samples were plated onto selective agars. ESBL producers were determined using phenotypic methods. Molecular characterization regarding virulence factors and phylogenetic grouping of ESBL-producing Escherichia coli was done using PCR. Isolates were also screened for the plasmid-mediated colistin resistance gene mcr-1. RESULTS: Among 175 pre-travel EPE-negative participants, 32% were positive upon return. No carbapenemase-producing Enterobacteriaceae were found, but one CTX-M-producing E. coli harboured mcr-1 (travel to Thailand). Most E. coli strains (43.1%) belonged to phylogroup A and were rarely associated with extraintestinal infections and a few (9.2%) expressed uropathogenicity pap genes. During 10-26 months of follow-up, no clinical infections were observed. Colonization rates varied by visited region: the Indian subcontinent, 49.2%; northern Africa, 44.0%; South-East Asia, 19.1%; and Turkey, 9.5%. Travellers' diarrhoea (OR 2.5, P = 0.04) or antimicrobial treatment during the trip (OR 5.9, P = 0.02) were both independent risk factors for EPE colonization. CONCLUSIONS: EPE acquired during travel have seemingly low pathogenicity, possibly indicating a low risk of clinical infection. Pre-travel advice should emphasize avoiding unnecessary antibiotic treatment during travel.

Human parvovirus B19: a review.

UNLABELLED: Parvovirus B19 (B19V) is a small non-enveloped single-stranded DNA (ssDNA) virus of the family Parvoviridae, the subfamily Parvovirinae, the genus Erythrovirus and Human parvovirus B19 type species. It is a common community-acquired respiratory pathogen without ethnic, socioeconomic, gender, age or geographic boundaries. Moreover, the epidemiological and ecological relationships between human parvovirus B19, man and environment have aroused increasing interest in this virus. B19V infection is associated with a wide spectrum of clinical manifestations, some of which were well established and some are still controversial, however, it is also underestimated from a clinical perspective. B19V targets the erythroid progenitors in the bone marrow by binding to the glycosphingolipid globoside (Gb4), leading to large receptor-induced structural changes triggering cell death either by lysis or by apoptosis mediated by the nonstructural (NS)1 protein. The pattern of genetic evolution, its peculiar properties and functional profile, the characteristics of its narrow tropism and restricted replication, its complex relationship with the host and its ample pathogenetic potential are all topics that are far from a comprehensive understanding. The lack of efficient adaptation to in vitro cellular cultures and the absence of animal models have limited classical virological studies and made studies on B19V dependent on molecular biology. The present review looks at the nature of this virus with the view to provide more information about its biology, which may be useful to the present and future researchers. KEYWORDS: human parvovirus B19; respiratory pathogen; biology; genome; fifth disease; transient aplastic crisis; anemia.

Interlocking intramedullary nailing in fracture shaft of the femur.

This prospective study was done to evaluate the result of interlocking intramedullary nailing in fracture shaft of the femur under the Department of Orthopaedic Surgery in Mymensingh Medical College Hospital during the period of January 2007 to December 2008. In this study total 66 patients were purposively selected for interlocking nailing initially but 6 patients did not report in subsequent follow up. So, the result of the study was based on 60 patients. There were 38 males and 22 females with the age range of 18 to 70 years, with an average age of 34 years. Motor vehicle accident was the most common cause of the fracture shaft of the femur (60%) and the second most common cause was fall from height (20%). Right sided involvement was more (66.67%). Majority of the patients had fracture lower third of the femur (70%). Among the patients farmer was the most common (33.33%) group and the next was housewife. The mean union time was 17 weeks with the range of 14 to 30 weeks. Postoperative complications were found, such as infection (3.33%) and nonunion (1.66%). The functional outcome of this study was evaluated by Klemm & Borner criteria. Excellent functional outcome was found in 80%, good in 15% and fair in 5%.

Incidence of pulmonary tuberculosis in garments workers of Dhaka City, Bangladesh.

This study was conducted to find out the incidence of Pulmonary Tuberculosis (PT) in garments workers of Dhaka city and to find-out the relationship between the incidence of PT and socio-demographic factors of the respondents. From all garments factories of Dhaka city, 30 factories were included by stratified random sampling method. Then workers were selected by simple random sampling technique. Following selection, detailed history was taken and recorded in a pre-tested questionnaire. Chest X-ray, Sputum for AFB, M.T and ESR were done in the suspected cases. PT was diagnosed when any patient fulfilled predefined inclusion criteria. Out of 2400 selected workers, 2281 workers were studied finally. A total of 22 (9.6 per 1000) definite PT cases were identified. Sputum positive were 4/2281 (1.75 per 1000) cases. All were diagnosed as new cases; none had received any treatment of tuberculosis in the past. The study concludes that PT among the garments workers is a more alarming health issue than among the general population of Bangladesh. Improved and regular health check-up system and 'directly observed treatment shortcourse' (DOTS) should be implemented in the working places particularly where clusters of workers are working together.

Human errors in medical practice: systematic classification and reduction with automated information systems.

We review the general nature of human error(s) in complex systems and then focus on issues raised by Institute of Medicine report in 1999. From this background we classify and categorize error(s) in medical practice, including medication, procedures, diagnosis, and clerical error(s). We also review the potential role of software and technology applications in reducing the rate and nature of error(s).

Biological control of mosquito larvae by Guppy fish.

Predation potentiality of a biological control agent, the guppy fish, Poecilia reticulata (= Lebistes reticulatus), was studied over the mosquito larvae under laboratory conditions. The third instar larvae of Culex quinquefasciatus mosquito were used as prey. The average consumption rate was 41.0 per day per fish. The female fish was more active (54.9) than male ones (27.0). The feeding activity was found to be higher at higher water temperature. The study suggests that this fish could be used, after careful field trial, as a promising and sustainable biological control agent in controlling filariasis and other mosquito-borne diseases.

An evaluation of workshop approach in research manpower development.

Effectiveness of organised training workshop on research methodology was assessed by administering pre and post-test questionnaire and analysis of the responses. A structured questionnaire containing 13 propositions, each having three options were used both for pre and post testing. Issues raised in the questionnaire relate to the rules, tools and techniques of biomedical research. The participants mean score for 5 days, 15 days and 30 days groups were 5,82; 7,33 and 5,41 respectively before the workshop. The corresponding scores after the workshop were 7,17; 9,42 and 8,67 respectively. The post-test scores were significantly higher (P < 0.01) than the pre-test scores and indicated that improvement in the participants' knowledge on research methodology had taken place.

Geographical distribution & seasonal pattern of diarrhoeal diseases in Bangladesh.

The district wise distribution and seasonal pattern of diarrhoeal diseases from 1987 to 1989 of Bangladesh are compiled and reported. The districts of Lalmonirhat, Kurigram, Gaibandha, Rajbari and Banderban showed higher incidences of diarrhoeal diseases to mean range of 8 and above. Among the remaining districts, 18 districts were in the medium ranges of incidences between 4 to less than 8% and 41 districts with lower range of incidences i.e. less than 4%. Two peaks of diarrhoeal diseases were found, once during the months of September-October in the post monsoon period and other during April-May.

Aged people in Bangladesh: facts and prospects.

PIP: The author reviews censuses up to 1981 to determine if there has been an increase in the size of the aged population in Bangladesh. Tables are included on both current and projected numbers of the aged by sex up to the year 2025.^ieng

Breastfeeding supplements in urban and rural areas of Bangladesh.

PIP: In 1982, a researcher studied breast feeding practices and supplementation of rice among 621 infants in Dhaka and 4 rural areas of Dhaka district, Bangladesh. At this time, the mean age for all the infants was 35.2 months. 3.3% of breast feeding urban mothers supplemented rice to their infants' diet within 3 months, while no rural mothers did so. Urban mothers were more likely to supplement earlier than rural mothers up until 21 months when the 2 sets of mothers were relatively equal (54.6 and 50.5% respectively). Thereafter the pattern switched to rural mothers being more likely to supplement rice to the diet of breast milk than were urban mothers. Further, 8% of urban mothers and 2.8% of rural mothers gave no rice at all to their infants up to the time of the survey. The younger the age at which the infant was given rice the more education the mother had, for example, urban: no education, 26.3 months; secondary school, 18.1; rural: no education, 23.8; secondary school, 22.1. Furthermore, if mothers worked, they were more likely to add rice to the diet at an earlier age than were those who stayed at home. The survey also indicated that both lower and higher family income groups in urban areas gave rice to their infants at higher ages than those in middle brackets. In rural areas, however, an erratic trend in the mean age of infant for rice by family income was observed. As for religion in urban areas, Hindu mothers supplemented rice to their infants' diet somewhat earlier than Moslem mothers, but in rural areas, the situation was opposite this. Older mothers in urban areas gave rice to their infants at a relatively lower age than the younger mothers. As for rural areas, the researcher noted no regular trend for age of mothers in the average age of the infants at which rice was supplemented.^ieng