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1.
Braz. j. biol ; 83: e244311, 2023. tab, graf
Artigo em Inglês | LILACS-Express | MEDLINE, LILACSEXPRESS | ID: biblio-1285616

RESUMO

Abstract Tuberculosis is a communicable disease with high morbidity and mortality rates in developing countries. The study's primary objective is to compare conventional methods such as acid-fast bacillus (AFB) culture and microscopy with rapid diagnostic methods. The secondary objective is to compare histopathological and microbiological findings in suspected patients with tubercular lymphadenitis. A total of 111 samples (August 2018 to September 2019) of lymph nodes were processed for AFB microscopy, AFB cultures, drug-susceptibility testing (DST), histopathology, and Xpert Mycobacterium Tuberculosis (MTB)/resistance to Rifampin (RIF) assays. Out of 111 lymph node samples, 6 (5.4%) were positive for AFB smear microscopy, 84 (75.6%) were positive for AFB culture, 80 (70.7%) were positive on Gene Xpert, and 102 (91.8%) were indicative of tuberculosis for histopathology studies. Mycobacteria growth indicator tube (MGIT) culture positivity was 84 (75.6%) higher than solid Lowenstein-Jensen (LJ) culture 74 (66.6%). Positive cultures underwent phenotypic DST. Two cases were Multidrug-resistant (MDR) on DST, while three cases were Rifampicin resistant on Gene Xpert. The sensitivity of Genexpert was (62%) against the conventional AFB culture method. The poor performance of conventional lymphadenitis diagnostic methods requires early and accurate diagnostic methodology. Xpert MTB/RIF test can help in the treatment of multidrug-resistant TB cases. Nonetheless, rapid and conventional methods should be used for complete isolation of Mycobacterium tuberculosis.


Resumo A tuberculose é uma doença transmissível com altas taxas de morbimortalidade nos países em desenvolvimento. O objetivo principal do estudo é comparar métodos convencionais, como cultura de bacilo álcool-ácido resistente (BAAR) e microscopia, com métodos de diagnóstico rápido. O objetivo secundário é comparar os achados histopatológicos e microbiológicos em pacientes com suspeita de linfadenite tubercular. Um total de 111 amostras (agosto de 2018 a setembro de 2019) de gânglios linfáticos foi processado ​​para microscopia de AFB, culturas de AFB, teste de susceptibilidade a drogas (DST), histopatologia e Xpert Mycobacterium tuberculosis (MTB)/ensaios de resistência à rifampicina (RIF). Das 111 amostras de linfonodos, 6 (5,4%) foram positivas para baciloscopia de AFB, 84 (75,6%) foram positivas para cultura de AFB, 80 (70,7%) foram positivas para o GeneXpert e 102 (91,8%) foram indicativas de tuberculose para estudos histopatológicos. A positividade da cultura do tubo indicador de crescimento de micobactérias (MGIT) foi 84 (75,6%), maior que a cultura sólida de Lowenstein-Jensen (LJ), 74 (66,6%). As culturas positivas foram submetidas a DST fenotípico. Dois casos eram multirresistentes (MDR) ao DST, enquanto três casos eram resistentes à rifampicina no GeneXpert. A sensibilidade do GeneXpert foi 62% contra o método convencional de cultura AFB. O fraco desempenho dos métodos convencionais de diagnóstico de linfadenite requer metodologia de diagnóstico precoce e precisa. O teste Xpert MTB/RIF pode ajudar no tratamento de casos de tuberculose multirresistente. No entanto, métodos rápidos e convencionais devem ser usados ​​para o isolamento completo do Mycobacterium tuberculosis.

2.
Braz J Biol ; 83: e240842, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34550279

RESUMO

This research aimed to investigate various mosquitocidal activities of Chenopodium botrys whole- plant n-hexane extract against Culex quinquefasciatus. The extract showed remarkable larvicidal, pupicidal, adulticidal, oviposition deterrent and adult emergence inhibitory activities against Cx. quinquefasciatus. During the larvicidal and pupicidal activities, the 24-hour lethal concentration (LC50) of extract against 2nd instar larvae, 4th instar larvae and pupae were 324.6, 495.6 and 950.8 ppm, respectively. During the CDC (Centers for Disease Control and Prevention) bottle bioassay for adulticidal activity, the median knockdown times (KDT50) at 1.25% concentration was 123.4 minutes. During the filter paper impregnation bioassay for adulticidal activity, the KDT50 value at 0.138 mg/cm2 concentration was 48.6 minutes. The extract was fractionated into 14 fractions through silica gel column chromatography which were then combined into six fractions on the basis of similar retention factor (Rf) value. These fractions were screened for adulticidal activity by applying CDC bottle bioassay. The fraction obtained through 60:40 to 50:50% n-hexanes-chloroform mobile phase with 0.5 Rf value showed 100% adulticidal activity at 0.2% concentration. During oviposition deterrent activity, the highest concentration (1000 ppm) showed 71.3 ± 4.4% effective repellence and 0.6 ± 0.1 oviposition activity index. During adult emergence inhibition activity, the median emergence inhibition (EI50) value was 312.3 ppm. From the outcome of the present investigation, it is concluded that the n-hexane extract of C. botrys whole- plant possesses strong larvicidal, pupicidal, adulticidal, oviposition deterrent and adult emergence inhibitory activities against Cx. quinquefasciatus.


Assuntos
Chenopodium , Culex , Inseticidas , Animais , Hexanos , Inseticidas/farmacologia , Larva , Extratos Vegetais/farmacologia , Folhas de Planta
3.
Braz J Biol ; 83: e244311, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34431905

RESUMO

Tuberculosis is a communicable disease with high morbidity and mortality rates in developing countries. The study's primary objective is to compare conventional methods such as acid-fast bacillus (AFB) culture and microscopy with rapid diagnostic methods. The secondary objective is to compare histopathological and microbiological findings in suspected patients with tubercular lymphadenitis. A total of 111 samples (August 2018 to September 2019) of lymph nodes were processed for AFB microscopy, AFB cultures, drug-susceptibility testing (DST), histopathology, and Xpert Mycobacterium Tuberculosis (MTB)/resistance to Rifampin (RIF) assays. Out of 111 lymph node samples, 6 (5.4%) were positive for AFB smear microscopy, 84 (75.6%) were positive for AFB culture, 80 (70.7%) were positive on Gene Xpert, and 102 (91.8%) were indicative of tuberculosis for histopathology studies. Mycobacteria growth indicator tube (MGIT) culture positivity was 84 (75.6%) higher than solid Lowenstein-Jensen (LJ) culture 74 (66.6%). Positive cultures underwent phenotypic DST. Two cases were Multidrug-resistant (MDR) on DST, while three cases were Rifampicin resistant on Gene Xpert. The sensitivity of Genexpert was (62%) against the conventional AFB culture method. The poor performance of conventional lymphadenitis diagnostic methods requires early and accurate diagnostic methodology. Xpert MTB/RIF test can help in the treatment of multidrug-resistant TB cases. Nonetheless, rapid and conventional methods should be used for complete isolation of Mycobacterium tuberculosis.


Assuntos
Mycobacterium tuberculosis , Tuberculose dos Linfonodos , Tuberculose Resistente a Múltiplos Medicamentos , Humanos , Rifampina/farmacologia , Rifampina/uso terapêutico , Tuberculose dos Linfonodos/diagnóstico
4.
Cell Tissue Res ; 386(1): 79-98, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34236518

RESUMO

The study of a desmoglein 2 murine model of arrhythmogenic cardiomyopathy revealed cardiac inflammation as a key early event leading to fibrosis. Arrhythmogenic cardiomyopathy (AC) is an inherited heart muscle disorder leading to ventricular arrhythmias and heart failure due to abnormalities in the cardiac desmosome. We examined how loss of desmoglein 2 (Dsg2) in the young murine heart leads to development of AC. Apoptosis was an early cellular phenotype, and RNA sequencing analysis revealed early activation of inflammatory-associated pathways in Dsg2-null (Dsg2-/-) hearts at postnatal day 14 (2 weeks) that were absent in the fibrotic heart of adult mice (10 weeks). This included upregulation of iRhom2/ADAM17 and its associated pro-inflammatory cytokines and receptors such as TNFα, IL6R and IL-6. Furthermore, genes linked to specific macrophage populations were also upregulated. This suggests cardiomyocyte stress triggers an early immune response to clear apoptotic cells allowing tissue remodelling later on in the fibrotic heart. Our analysis at the early disease stage suggests cardiac inflammation is an important response and may be one of the mechanisms responsible for AC disease progression.

5.
Artigo em Inglês | MEDLINE | ID: mdl-33896009

RESUMO

INTRODUCTION: Placenta accreta spectrum (PAS) is a serious condition with a mortality as high as 7%. However, the factors associated with this type of death have not been adequately described, with an almost total lack of publications analyzing the determining factors of death in this disease. The aim of our work is to describe the causes of death related to PAS and to analyze the associated diagnosis and treatment problems. MATERIAL AND METHODS: This is an inter-continental, multicenter, descriptive, retrospective study in low- and middle-income countries. Maternal deaths related to PAS between January 2015 and December 2020 were included. Crucial points in the management of PAS, including prenatal diagnosis and details of the surgical treatment and postoperative management, were evaluated. RESULTS: Eighty-two maternal deaths in 16 low- and middle-income countries, on three continents, were included. Almost all maternal deaths (81 cases, 98.8%) were preventable, with inexperience among surgeons being identified as the most relevant problem in the process that led to death among 87% (67 women) of the cases who had contact with health services. The main cause of death associated with PAS was hemorrhage (69 cases, 84.1%), and failures in the process leading to the diagnosis were detected among 64.6% of cases. Although the majority of cases received medical attention and 50 (60.9%) were treated at referral centers for severe obstetric disease, problems were identified during treatment in all cases. CONCLUSIONS: Lack of experience and inadequate surgical technique are the most frequent problems associated with maternal deaths in PAS. Continuous training of interdisciplinary teams is critical to modify this tendency.

6.
Mymensingh Med J ; 28(3): 586-594, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31391431

RESUMO

Open lumbar discectomy is the gold standard surgical procedure for intervertebral disc herniation but still controversy exit whether limited or aggressive open discectomy provides better outcomes. Retrospectively we evaluate 2380 patients to compare the clinical outcomes, complications and recurrence rate between limited (LD) and aggressive open discectomy (AD). Records of 745 men and 255 women aged 19 to 55 (mean, 38.03±9.1) years for LD and 995 men and 385 women aged 21 to 60 (mean, 43.7±9.3) years for AD were reviewed. Demographic data, surgical data, complications and re-herniation rate were collected and assessment done by Visual analogue score (VAS), Oswestry Disability Index (ODI) and modified Mcnab criteria. The mean follow-up period was 24.5 and 28.8 months respectively. In compare to aggressive discectomy, limited discectomy required significantly less operative time (95 vs. 55 minutes, p<0.001, unpaired 't' test), less used of post-operative analgesic (p<0.05) and better patients' satisfaction (p<0.05). But low back pain, leg pain, recurrence rate, infection, per-operative blood loss and periods of hospitalization were without significant difference. Both groups achieved satisfactory clinical outcomes 85%, 78.62 % respectively. Complications were foot drop (n=2, 5), dural tear (n=7, 14), superficial wound infection (n=7, 17) and discitis (n=19, 37) and reherniation (55, 64) respectively. Limited discectomy is an alternative to the aggressive discectomy. Both groups showed satisfactory outcome but in limited discectomy group shown better satisfaction in relation to aggressive discectomy.


Assuntos
Discotomia , Deslocamento do Disco Intervertebral , Disco Intervertebral , Adulto , Discotomia/métodos , Feminino , Humanos , Deslocamento do Disco Intervertebral/cirurgia , Vértebras Lombares , Masculino , Pessoa de Meia-Idade , Prolapso , Estudos Retrospectivos , Resultado do Tratamento
7.
Mymensingh Med J ; 28(1): 182-192, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30755568

RESUMO

Spine injuries, a common component in Polytrauma are usually affects the young people and is a major cause of morbidity and poses a significant health care expenditure and considerable threats to survival and quality of life. We retrospectively assess the demographics, incidence, mode of trauma, associated spine injuries, complications, neurological improvement and mortality. Records of total 1695 admitted patients, spinal injuries were 262 patients. Among them 30(11.45%) patients were associated with Polytrauma victims. Eleven patients (36.67%) were admitted through Ortho emergency dept, 14(46.67%) patients through Intensive care unit (ICU), 5(16.66%) patients through other department (CVS, Urology). Most (56%) of the patients were young in the age range of 16 to 40 years. Cervical spines were most commonly (44%) affected followed by lumbar (31%), thoracic (13%), thoraco-lumbar (9%) and Cervico-thoracic (3%) spines. Road traffic accident was the common cause (80%). Twelve patients (40%) had problems at various steps of management and maximum problems occur in step III. Nineteen patients (63.33%) management needs co-ordination between various specialties. Significant number of patients (76.67%) required operative treatment (p<0.05) and 13.33% were managed conservatively. Mortality rate (10%) was insignificant (p>0.05%). Of these patients, 73.33% had shown neurological improvement of at least one ASIA grade. The treatment of spinal injury in polytrauma patient should follow the principle of Advanced Trauma Life Support (ATLS). Once life and limb-threatening injuries have been identified and addressed, suspected spinal cord injury patients should be immobilized as early as possible to reduced the secondary injury, improve motor and sensory function as well as reduced the extend of permanent paralysis.


Assuntos
Traumatismo Múltiplo/cirurgia , Traumatismos da Medula Espinal/cirurgia , Traumatismos da Coluna Vertebral/cirurgia , Adolescente , Adulto , Feminino , Humanos , Escala de Gravidade do Ferimento , Masculino , Traumatismo Múltiplo/epidemiologia , Qualidade de Vida , Estudos Retrospectivos , Traumatismos da Medula Espinal/epidemiologia , Traumatismos da Coluna Vertebral/epidemiologia , Centros de Atenção Terciária , Resultado do Tratamento , Adulto Jovem
8.
Mymensingh Med J ; 26(4): 762-774, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29208863

RESUMO

The treatment of unstable thoracolumbar junction burst fractures remains a controversial issue. We evaluate the efficacy of short segment (SS) compared with that of long-segment (LS) stabilization in terms of clinical and the radiological outcomes. Records of 88 patients with thoracolumbar burst fracture underwent posterior pedicle screw fixation from January 2004 to December 2015, studied retrospectively. These patients were divided into two groups: SS and the LS-group. Clinical parameters: back pain, disability, neurological deficit and radiologic parameters: Cobb angle, sagittal index, the kyphotic deformation of vertebral body, vertebral height and canal compromise were measured before surgery and immediately after surgery and at 3, 6 and 12 months postoperatively. Overall outcomes were evaluated using the modified Mcnab criteria at the last follow-up. Chi-squared test and paired-t test were used for statistical analysis using SPSS. There were 36 and 52 patients in the SS and LS- group, respectively. The mean age of the patients was 30.6±8.4 and 33.4±8.4 years and the mean follow-up period was 24.5 and 16.8 months in SS and LS-group respectively. In the SS-group, the fractured vertebral body level was L1, T12, L2, T11 and T10 in 15, 10, 6, 3 and 2 cases and LS- group, the fractured vertebral body level was L1, T12, L2, T11 and T10 in 22, 17, 5, 5 and 3 cases, respectively. Both groups achieved satisfactory clinical outcomes according to the modified Mcnab criteria. In the SS-group, 8(22.22%), 21(58.33%) and 7(19.44%) cases were considered to have excellent, good and fair outcome and LS-group, 18(34.61%), 25(48.08%), 6(11.54%) and 3(5.77%) cases were considered to have excellent, good, fair, and poor outcome, respectively. Short-segment pedicle screw fixation including the fractured vertebral body might be as effective as long-segment pedicle screw fixation for the treatment of unstable thoracolumbar junction burst fracture.


Assuntos
Fraturas da Coluna Vertebral , Adulto , Fixação Interna de Fraturas , Humanos , Vértebras Lombares/cirurgia , Estudos Retrospectivos , Fraturas da Coluna Vertebral/cirurgia , Vértebras Torácicas/cirurgia , Resultado do Tratamento , Adulto Jovem
9.
Mymensingh Med J ; 26(3): 558-568, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28919610

RESUMO

To review outcome of 25 patients who underwent open-door cervical laminoplasty for multilevel cervical spondylotic myelopathy (MCSM) and ossification of the posterior longitudinal ligament (OPLL) using titanium reconstruction miniplate and screws. Records of 18 men and 7 women aged 35 to 78 (mean, 62.6) years were reviewed retrospectively from October 2009 and October 2014 at Bangabandhu Sheikh Mujib Medical University (BSMMU) and in our private settings, Dhaka, Bangladesh. Four patients had 5 levels (C3-C7), 21 patients had 4 levels (C3-C6) decompression and 3 patients (12%) performed foraminotomies. A total of 104 laminae were opened, all of them were fixed with a titanium reconstruction miniplates. In 21 patients, a 20-hole titanium miniplate bent to the contour of a lamina was used and fixed into 4 laminae and 4 patients fixed in 5 laminae levels. In most patients, screw fixation was unicortical and no spacer or bone graft was used. Demographic and surgical data were collected and clinical outcomes were assessed with neck pain score, neck disability index and Nurick's grading. Outcome analysis was done using Odom's criteria. The mean follow-up duration was 1.8 (range, 1-5) years. Diagnoses were MCSM (n=20), OPLL (n=5). Mean estimated blood loss (EBL) was 120ml (range: 50-200), mean surgery time was 153 min (range: 75-240). Following Nurick's grading, 23 patients (92%) improved, 2 (08%) had the same Nurick grade. No intraoperative complications were noted and average hospital stay was 6.12 days (range: 5 to 9). Significance improvements in overall NDI scores occurred at 1 year follow up (p<0.002). Radiographic evaluation showed an increase in the mean sagittal diameter from 13.3mm at pretreatment to 19.4mm post surgery. Two patients developed transient C5 palsy. Open-door Laminoplasty technique is safe, easy and achieves a good canal expansion and neurological recovery and can be used as an alternative treatment for cases of MCSM and OPLL patients without instability.


Assuntos
Laminoplastia , Doenças da Medula Espinal , Adulto , Idoso , Bangladesh , Vértebras Cervicais , Feminino , Seguimentos , Humanos , Laminectomia , Laminoplastia/métodos , Ligamentos Longitudinais , Masculino , Pessoa de Meia-Idade , Ossificação do Ligamento Longitudinal Posterior , Osteogênese , Estudos Retrospectivos , Doenças da Medula Espinal/cirurgia , Titânio , Resultado do Tratamento
10.
Mymensingh Med J ; 25(3): 514-22, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27612900

RESUMO

Results of 63 surgically treated intradural spinal tumors between the period of October 2003 and December 2014 at Bangabandhu Sheikh Mujib Medical University (BSMMU) and in our private settings, Dhaka, were analyzed retrospectively. There were 33 males, 30 females with an average age of 52.4 years (13-70 years) and followed up for at least a year. The preoperative symptom with duration, tumors location and intradural space occupancy and the histopathological diagnosis were analyzed. Pain was evaluated by the visual analogue scale (VAS) and the neurologic function was assessed by Nurick's grade. The tumors were located as, thoracic (n=32, 50.79%), lumbar (n=16, 25.39%), cervical (n=05, 07.93%), and junctional (n=10, 15.87%, CervicoThoracic-01, Thoracolumbar-09). The histopathological diagnosis included schwannoma (n=30, 47.7%), meningiomas (n=14, 22.3%), neurofibroma, arachnoid cyst and myxopapillary ependymoma (n=03, 04.76%) each and paraganglioma (n=01, 01.59%). Among the intramedullary tumors, ependymoma (n=03, 04.76%), astrocytoma and epidermoid cyst (n=02, 03.17%), haemangioblastoma, paraganglioma and cavernous haemangioma (n=01, 01.59%) each. The VAS score was reduced in all cases from 8.0±1.2 to 1.2±0.8 (p<0.003) and the Nurick's grade was improved in all cases from 3.0±1.3 to 1.0±0.0 (p<0.005). The preoperative neurological deficit improved within 8 postoperative weeks in most cases and within 1 postoperative year in all cases. Complications included cerebrospinal fluid leakage, parasthesia and further neurological deterioration (Astrocytoma) (n=02, 03.17%) and dependant bedsore and recurrence (Ependymoma) (n=01, 01.59%). Aggressive surgical excision potentially minimizes neurologic morbidity and improved outcome except intramedullary tumors where initial treatment consists of maximum safe surgical resection or biopsy.


Assuntos
Neoplasias Meníngeas , Neoplasias da Medula Espinal , Neoplasias da Coluna Vertebral , Adolescente , Adulto , Idoso , Bangladesh , Feminino , Humanos , Masculino , Neoplasias Meníngeas/cirurgia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Estudos Retrospectivos , Neoplasias da Medula Espinal/cirurgia , Neoplasias da Coluna Vertebral/cirurgia , Resultado do Tratamento , Adulto Jovem
11.
Mymensingh Med J ; 25(2): 289-95, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27277362

RESUMO

There have been an association between systemic diseases and hormonal changes particularly diabetes which has been cited as a risk factor in the progression of periodontitis in pregnant women. The incidence and severity of periodontal diseases are increasing at a higher rate and a common condition in pregnant diabetic women among Bangladeshi population. This cross sectional study included 200 pregnant women who were selected from gynecological department and examined at the dental unit. The clinical parameters used were the Silness and Loe plaque index (PI), gingival scores and periodontal status and any relationship to socio demographic variables (age, occupation, level of education and urban or rural residence) and clinical variables (gestation period, previous pregnancy, type of diabetes and periodontal maintenance) were evaluated. The results showed that these clinical parameters increased concomitantly with an increase in the stage of pregnancy and in women with multiple pregnancies. Increased age, lower level of education, unemployment and patients residing in rural areas were associated with significantly higher gingival scores and periodontal measures. Women with increased age and multiple pregnancies usually have less interest to frequent periodontal maintenance showing a significant statistical relation between an increased age and changes in gingival and periodontal status; however no significant association was found between increased age and plaque index. It is concluded that gingival inflammatory symptoms are aggravated during pregnancy in diabetic women and are related to different clinical and demographic variables.


Assuntos
Diabetes Mellitus/epidemiologia , Doenças Periodontais/epidemiologia , Adolescente , Adulto , Bangladesh/epidemiologia , Comorbidade , Estudos Transversais , Diabetes Mellitus/etiologia , Diabetes Gestacional/epidemiologia , Diabetes Gestacional/etiologia , Feminino , Humanos , Doenças Periodontais/etiologia , Gravidez , Gravidez em Diabéticas/epidemiologia , Gravidez em Diabéticas/etiologia , Fatores de Risco , Adulto Jovem
12.
Waste Manag ; 35: 187-90, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25445259

RESUMO

Food wastes with high moisture and organic matter content are likely to emit odours as a result of the decomposition process. The management of odour from decomposing wastes is needed to sustain the interest of residents and local councils in the source separation of kitchen wastes. This study investigated the potential of baking soda (at 50 g, 75 g and 100g per kg food waste) to control odour from seven days stored food waste. It was found that 50 g of baking soda, spread at the bottom of 8l food wastes bin, can reduce the odour by about 70%. A higher amount (above 100g) is not advised as a pH higher than 9.0 may be induced leading to the volatilization of odorous ammonia. This research finding is expected to benefit the waste management sector, food processing industries as well as the local authorities where malodour from waste storage is a pressing issue.


Assuntos
Odorantes/prevenção & controle , Bicarbonato de Sódio/química , Gerenciamento de Resíduos/métodos , Amônia/química , Ácidos Graxos Voláteis/análise , Ácidos Graxos Voláteis/química , Alimentos , Concentração de Íons de Hidrogênio , Odorantes/análise , Gerenciamento de Resíduos/instrumentação , Resíduos
13.
Mymensingh Med J ; 23(3): 471-9, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25178598

RESUMO

Isthmic spondylolisthesis (IS) is the most common spondylolytic disorders and one of the most common causes of low back pain and sciatica in adolescents and adults. Although the initial management is conservative, surgery is often the ultimate solution. Interbody fusion has been found superior and replaced the gold standard postero-lateral fusion. Transforaminal Lumbar Interbody Fusion (TLIF) has been associated with fewer complications and has become the choice of surgery. This study was done to evaluate the clinical, radiological and functional outcome of TLIF in Low Grade Isthmic Spondylolisthesis (LGIS). The clinical records of 46 consecutive patients within the age range of 31 to 60 years, who had symptomatic unstable Low Grade Isthmic Spondylolisthesis (LGIS) with or without unilateral radiculopathy in Bangabandhu Sheik Mujib Medical University (BSMMU) and private settings, from April 2007 to March 2012 were reviewed with 2 year completed follow-up. Patients were evaluated for pain by Visual Analogue Score (VAS), Disability by Oswestry Disability Index (ODI), radiological fusion by Brantigan and Steffee criteria, reduction of listhesis by Taillard's method and the overall functional outcome by the Macnab's criteria. Pain (Low back and leg), disability, neurological status had highly significant (p<0.001, paired t test) improvement. Forty two (91.30%) cases achieved satisfactory radiological fusion with overall 30% reduction of slip. Satisfactory outcome was reached in 45(97.83%) cases. Transforaminal Lumbar Interbody Fusion results in significant improvement of clinical, radiological and functional debility of symptomatic LGIS in adults.


Assuntos
Vértebras Lombares/cirurgia , Fusão Vertebral/métodos , Espondilolistese/cirurgia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escala Visual Analógica
14.
Mymensingh Med J ; 22(4): 798-806, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24292314

RESUMO

This prospective interventional study carried out at Bangabandhu Sheikh Mujib Medical University and a private hospital in Dhaka, Bangladesh during the period from October 2003 to September 2011. Surgical treatment of degenerative disc disease (DDD) should aim to re-expand the interbody space and stabilize until fusion is complete. The present study conducted to find out the efficacy of using interbody fusion device (Cage) to achieve interbody space re-expansion and fusion in surgical management of DDD. We have performed the interventional study on 53 patients, 42 female and 11 male, with age between 40 to 67 years. All the patients were followed up for 36 to 60 months (average 48 months). Forty seven patients were with spondylolisthesis and 06 with desiccated disc. All subjects were evaluated with regard to immediate and long term complications, radiological fusion and interbody space re-expansion and maintenance. The clinical outcome (pain and disability) was scored by standard pre and postoperative questionnaires. Intrusion, extrusion and migration of the interbody fusion cage were also assessed. Forty seven patients were considered to have satisfactory outcome in at least 36 months follow up. Pseudoarthrosis developed in 04 cases and 06 patients developed complications. In this series posterior lumbar interbody fusion (PLIF) with interbody cage and instrumentation in DDD showed significant fusion rate and maintenance of interbody space. Satisfactory outcome observed in 88.68% cases.


Assuntos
Vértebras Lombares/cirurgia , Fusão Vertebral/instrumentação , Espondilolistese/cirurgia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
15.
Waste Manag ; 32(12): 2426-30, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22819598

RESUMO

Research was conducted to determine suitable chemical parameters as indicators of odor from decomposing food wastes. Prepared food scraps were stored in 18 l plastic buckets (2 kg wet weight each) at 20 °C and 8 °C to reproduce high and low temperature conditions. After 1, 3, 7, 10 and 14 days of storage, the odor from the buckets were marked to an intensity scale of 0 (no odor) to 5 (intense) and the corresponding leachate analyzed for volatile fatty acids, ammonia and total organic carbon. A linear relationship between odor intensity and the measured parameter indicates a suitable odor indicator. Odor intensified with longer storage period and warmer surroundings. The study found ammonia and isovaleric acid to be promising odor indicators. For this food waste mixture, offensive odors were emitted if the ammonia and isovaleric acid contents exceeded 360 mg/l and 940 mg/l, respectively.


Assuntos
Amônia/química , Ácidos Graxos Voláteis/química , Alimentos , Odorantes/análise , Eliminação de Resíduos , Resíduos Sólidos/análise , Temperatura
16.
J Clin Ultrasound ; 38(4): 177-81, 2010 May.
Artigo em Inglês | MEDLINE | ID: mdl-20146214

RESUMO

BACKGROUND: We investigated whether microvascular enhancement on contrast-enhanced sonographic (CEUS) imaging can aid in distinguishing between benign and malignant lesions and correlated these findings with histopathological findings. METHOD: Fifteen patients with a palpable breast mass were recruited. Following informed consent, 4.8 mL of the microbubble contrast agent SonoVue was injected intravenously. Digital video clips of lesion enhancement were obtained and reviewed by a consultant radiologist who scored each lesion on the following characteristics: homogeneous versus heterogeneous enhancement, the presence or absence of focal defects, well- versus ill-defined margins and vascular morphology score (VMS). RESULT: Histologically there were 7 malignant and 8 benign lesions. The calculated sensitivity for CEUS in the diagnosis of malignancy was 100%, with a 37.5% specificity. There was no statistically significant difference in overall mean VMS between the malignant and benign lesions. CONCLUSION: The results of our study have not shown any additional benefit in the use of CEUS over conventional triple assessment. The positive trend seen in the higher mean VMS for the malignant tumors needs further investigation with a larger cohort of patients.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Meios de Contraste , Aumento da Imagem/métodos , Fosfolipídeos , Hexafluoreto de Enxofre , Ultrassonografia Mamária/métodos , Adulto , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Microbolhas , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Adulto Jovem
17.
Br J Radiol ; 81(965): e149-53, 2008 May.
Artigo em Inglês | MEDLINE | ID: mdl-18440938

RESUMO

Breast metastases from non-breast primaries are rare in female patients and exceedingly rare in male patients, with only a handful of cases described. Lymphoma, metastatic melanoma and bronchial carcinoma are the primary sites for the majority of breast metastases. Breast metastases from colorectal carcinoma have been described previously in only a small number of cases in the literature. Here, we report a further two patients with biopsy-proven colorectal carcinoma metastases to both breasts, who demonstrate contrasting unusual and atypical imaging features that have not been reported previously. In one case, the imaging appearances mimic a multifocal primary breast carcinoma. Metastatic disease in the breast is a marker for disseminated metastatic spread, with a correspondingly poor prognosis. Therefore, we review the imaging features that differentiate metastatic breast disease from multifocal breast primaries, which are important to recognize because the management options for these patients differ greatly.


Assuntos
Neoplasias da Mama/secundário , Neoplasias Colorretais , Idoso , Neoplasias da Mama/diagnóstico por imagem , Feminino , Humanos , Mamografia/métodos , Pessoa de Meia-Idade , Ultrassonografia Mamária/métodos
18.
Dalton Trans ; (14): 1932-6, 2008 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-18369501

RESUMO

The crystalline photochromism of a diarylethene pyridyl ligand is applied to the modulation of the electronic environment of a high-spin Fe(II) metal ion.


Assuntos
Compostos Ferrosos/química , Magnetismo , Cristalografia por Raios X , Elétrons , Ligantes , Modelos Moleculares , Estrutura Molecular , Fotoquímica , Piridinas/química , Tiocianatos/química
19.
Eur Child Adolesc Psychiatry ; 13(2): 83-91, 2004 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-15103533

RESUMO

BACKGROUND: Using an empirically derived instrument to reduce the assessor bias inherent in structured diagnostic interviews, we sought to re-examine and validate the putative comorbidity between Obsessive Compulsive Disorder (OCD) and Attention-Deficit/Hyperactivity Disorder (ADHD) in children and adolescents. METHOD: We examined the correlation between Child Behavior Checklist (CBCL) syndrome, competence, and composite scores in children with: 1) OCD plus ADHD (OCD + ADHD), N = 47; 2) OCD without comorbid ADHD (OCD), N = 33; 3) ADHD without comorbid OCD (ADHD) N = 43; and 4) comparison controls recruited from general pediatric clinics,N = 32. RESULTS: CBCL findings in our ADHD children were similar to previous findings reported in ADHD youth, irrespective of the presence or absence of comorbid OCD. Comorbid youth generally had additive scores on the CBCL scales, reflecting the independent contribution of symptomatic and functional impairment from each disorder. CONCLUSION: These findings suggest that when ADHD-like symptoms are seen in OCD youth, they reflect a true comorbid state of OCD plus ADHD. The CBCL may provide a rapid assessment tool to identify comorbid ADHD in OCD youth.


Assuntos
Comportamento do Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Comportamento Infantil , Transtorno Obsessivo-Compulsivo/epidemiologia , Adolescente , Comportamento do Adolescente/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Criança , Comportamento Infantil/psicologia , Transtornos do Comportamento Infantil/epidemiologia , Comorbidade , Feminino , Humanos , Masculino , Massachusetts/epidemiologia , Transtorno Obsessivo-Compulsivo/diagnóstico , Determinação da Personalidade/normas , Psicologia do Adolescente , Psicologia da Criança , Fatores de Risco , Índice de Gravidade de Doença , Inquéritos e Questionários
20.
Pacing Clin Electrophysiol ; 20(6): 1636-45, 1997 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-9227761

RESUMO

While abnormalities in the P wave SAECG have been associated with the occurrence of AF, its reproducibility has never been documented. The purpose of this study was to evaluate the immediate and short-term reproducibility of measurements from the P wave SAECG. P wave SAECGs were obtained using well-described techniques that utilize the QRS complex as the trigger and the P wave as template for averaging. In 28 subjects (8 controls, 11 with cardiac disease, 9 with prior AF), 3 P wave SAECGs were obtained: an initial study; on immediate reacquisition; and reacquisition after 4-5 days. Vector duration and RMS voltage of the terminal 20 ms of the P wave SAECG were measured and compared. The mean P wave duration was 152 +/- 14 ms on initial SAECG, 152 +/- 14 ms and 152 +/- 15 ms at immediate and short-term reacquisitions, respectively (both P = NS vs initial). The mean terminal RMS voltage was 6.4 +/- 6.0 mcV on initial SAECG, 6.4 +/- 5.9 mcV and 6.5 +/- 5.8 mcV at immediate and short-term reacquisitions, respectively (both P = NS vs initial). Linear regression analysis showed high reproducibility for both P wave duration (r = 0.94 for immediate and r = 0.96 for short-term reacquisition vs initial) but slightly less for terminal RMS voltage (r = 0.92 for immediate and r = 0.84 for short-term reacquisition vs initial). In subgroup analysis, P wave duration measurements were highly reproducible in controls, in subjects with cardiac disease, and in those with a history of AF. P wave duration was also reproducible for both males and females, as well as for subjects age > 65 years (r = 0.96 and 0.89 for immediate and short-term reacquisition, respectively). Terminal RMS voltage measurements were reproducible for controls, but less reproducible in other subgroups. In conclusion, P wave duration measurements on SAECG are reproducible when evaluated at immediate and short-term reacquisition regardless of age, sex, cardiac disease, or prior AF. Terminal RMS voltages were less reproducible, especially in patients with cardiac disease and/or prior AF. These findings may explain conflicting observations regarding the clinical utility of terminal P wave measurements.


Assuntos
Fibrilação Atrial/diagnóstico , Eletrocardiografia/métodos , Cardiopatias/diagnóstico , Processamento de Sinais Assistido por Computador , Fatores Etários , Fibrilação Atrial/epidemiologia , Estudos de Casos e Controles , Feminino , Cardiopatias/epidemiologia , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Fatores Sexuais , Fatores de Tempo
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