Peptic Ulcer Disease in Bangladesh: A Multi-centre Study.

The incidence of peptic ulcer has steadily declined through out the world. This decreasing trend is also noticeable in this subcontinent. The point prevalence of peptic ulcer (PUD) in Bangladesh was around 15% in eighties. The aim of this study was to see the present prevalence of peptic ulcer at endoscopy and to identify changing trends in the occurrence of peptic ulcer in Bangladesh. This retrospective analysis of the endoscopic records of multiple tertiary referral centres of Dhaka city were done from January 2012 to July 2013. A total of 5608 subjects were the study samples. We included those patients having peptic ulcer in the form of duodenal ulcer, benign gastric ulcer including pre-pyloric ulcer and gastric outlet obstruction due to peptic ulcer. Duodenal ulcer and benign gastric ulcer were found in 415(7.4%) and 184(3.28%) patients respectively and gastric outlet obstruction due to peptic ulcer was found in 23(0.40%) patients.

Pattern of Changes in the Findings among the Patients Undergoing Diagnostic Esophagogastroduodenoscopy in Bangladesh.

This cross-sectional observational study was conducted in the Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University, Sir Salimullah Medical College and Mitford Hospital, Holy family Red Crescent Medical College and Hospital and Popular Diagnostic Centre, Shantinagar branch, Dhaka, Bangladesh from January 2012 to July 2013. Study subjects were included in the study irrespective of age and sex having different upper GI tract. Complaints like dysphagia, heart burn, abdominal pain/dyspepsia, nausea, vomiting, haematemesis and/or malena, anorexia, unexplained anemia, weight loss etc. All the findings of oesophagus, stomach and duodenal lesions were observed and data were recorded. The results were considered positive based on the macroscopic appearance using standard diagnostic criteria. During the study period endoscopy was performed in 5608 subjects. Among which 2968(52.92%) were male and 2640(47.07%) were female. The patients age range from 7 years to 108 years. The majority of the patients were from 40-50 years. Normal findings were observed among 3321(59.21%) cases. Gastroduodenal erosions were present among 684(12.19%) cases, Oesophageal varices in 444(7.91%) cases, duodenal ulcer diseases in 415(7.40%) cases and gastric ulcer in 184(3.28%) cases. Ca stomach was found among 165(2.94%) cases. A number of diseases were identified through this procedure. Current study observed a large proportion of patients (40.79%) had positive upper GI endoscopy.

Clinico-epidemiological Characteristics of the Physician Affected with Covid-19.

Coronavirus disease 2019 (Covid-19) disease have been associated with significant mortality amongst doctors globally including Bangladesh. To delineate the clinico-epidemiological characteristics of the physician affected with Covid-19 was the objective of the study. This cross-sectional 'Facebook' based survey was conducted in the period of August 2020 to September 2020. Snowball sampling methods was followed. A total of 151 physicians affected with Covid-19 participated in this survey. Self-reported perceived severity scale (zero meaning not severe at all and ten denoting the most severe) was used. Collected data were analyzed by SPSS 25.0. Among the participants, the majority were male, 98(64.9%). The most prevalent affected age groups were 24-35 years 131(86.8%). Approximately 45.0% worked in COVID dedicated hospital. Entry-level physicians (Medical Officer or Assistant Surgeon) were the most affected 117(94.4%). One-third of the physicians had at least the one co-morbidity. Bronchial asthma, obesity and diabetes were the most frequent. Predominate symptoms of the infection were fever 94(62.3%), cough 94(62.3%) and myalgia 92(60.9%). Half of the participants had sore throat, anosmia, gastro-intestinal symptoms and one-third of the patients developed dyspnea. Perceived severity of the symptoms ranged between 2 and 6. The pattern of drug use to prevent the Covid-19 showed no uniformity. However, intake of Zinc, Vitamin C, Vitamin D, antihistamine and Ivermectin was found in 74.8%, 67.5%, 41.7%, 49.0% and 37.7% respectively. As the current pandemic continues to evolve, physicians must be equipped with appropriate knowledge, skills and must be cautious on the prevention measures against Covid-19.

A study on measuring the 222Rn in the Buriganga River and tap water of the megacity Dhaka.

Radon (222Rn), an inert gas, is considered a silent killer due to its carcinogenic characteristics. Dhaka city is situated on the banks of the Buriganga River, which is regarded as the lifeline of Dhaka city because it serves as a significant source of the city's water supply for domestic and industrial purposes. Thirty water samples (10 tap water from Dhaka city and 20 surface samples from the Buriganga River) were collected and analyzed using a RAD H2O accessory for 222Rn concentration. The average 222Rn concentration in tap and river water was 1.54 ± 0.38 Bq/L and 0.68 ± 0.29 Bq/L, respectively. All the values were found below the maximum contamination limit (MCL) of 11.1 Bq/L set by the USEPA, the WHO-recommended safe limit of 100 Bq/L, and the UNSCEAR suggested range of 4-40 Bq/L. The mean values of the total annual effective doses due to inhalation and ingestion were calculated to be 9.77 µSv/y and 4.29 µSv/y for tap water and river water, respectively. Although all these values were well below the permissible limit of 100 µSv/y proposed by WHO, they cannot be neglected because of the hazardous nature of 222Rn, especially considering their entry to the human body via inhalation and ingestion pathways. The obtained data may serve as a reference for future 222Rn-related works.

Expression of Toll-like receptors and avian ß-defensins and their changes in response to bacterial components in chicken sperm.

The aim of the present study was to examine whether chicken sperm express mRNA of Toll-like receptors (TLR) and avian ß-defensins (avBD), and whether the expression of avBD in the sperm are regulated by the interaction of TLR-2 and TLR-4 with their corresponding ligands. Total RNA was extracted from fresh sperm and mRNA expression for TLR and avBD were examined by reverse-transcription PCR. Changes in the expression of avBD-5, avBD-9, avBD-10, and avBD-12 in the sperm after incubation with lipopolysaccharide (LPS; TLR-4 ligand) or lipopeptide (Pam3CSK4; TLR-2 ligand) were examined by real-time PCR. Among 8 types of TLR, PCR products of 7 types, namely, TLR-2 to TLR-5, TLR-7, TLR-15, and TLR-21, were identified in the sperm. The sperm also expressed cluster of differentiation 14 (CD14), which is required for the binding of LPS to TLR-4. Out of 14 avBD types reported in the chicken, a total of 9 types, namely, avBD-1, avBD-3, avBD-5, and avBD-7 to avBD-12 were expressed by the sperm, whereas avBD-5, avBD-9, avBD-10, and avBD-12 showed dense signals on the gel. Expression levels of avBD-5, avBD-9, avBD-10, and avBD-12 were significantly increased in the sperm stimulated with LPS, and that of avBD-5 was also enhanced by Pam3CSK4. These results suggest that avian sperm have the ability of the innate host defense to protect themselves from infection in the male and female genital tracts.

Anorectal Malformations and Associated Anomalies in Children.

Anorectal malformations (ARM) incorporate a broad spectrum of diseases, can affect both sexes, and involve the distal anus and rectum as well as the uro-genital tracts. Defects range from the minor which can be treated easily with an excellent outcome, to those are complex and often associated with other anomalies are difficult to manage with poor functional prognosis. This study was done to observe the hospital incidence of Anorectal malformations, frequency of types, sex distribution and spectrum of associations with ARM. The effects of presence of associated anomalies on morbidity and mortality also observed. Detailed history, clinical examinations and relevant investigations were performed for the primary and as well as the associated anomalies. A total of 80 patients were admitted in the department of pediatric surgery in Mymensingh Medical College Hospital during the period of June 2016 to May 2017. Age of the patients was ranging from 1-180 days with the mean age of 0.49±1.002 months. Male: Female ratio was 1.6: 1. Among them 48(60%) were high and 32(40%) were low variety of ARM. In male 37(46.2%) had high and 13(13.7%) were low variety whereas in female 11(13.7%) were high and 19(23.7%) had low ARM. Associated anomalies were seen in 25(31.2%) patient -18 in males and 7 in females; 20 in high and 5 in low ARM. Associated anomalies were uro-genital 11(13.8%), cardiovascular 10(12.5%), vertebral 4(5%), limb defects 3(3.5%) and others 2(2.5%). Four patients have more than one anomaly. Anorectal malformations occur more in boys than girls. Males were more likely to have high lesions and without fistula was the common defect. Low variety ARM were found more in females with Anovestibular fistula is the commonest defect. The most common associated anomalies were recto urinary fistula (13.8%). Associations were more in high than low ARM but not significant (p>0.05). Post operative complications were more in high ARM in both sexes with associated anomalies. The effects of types and associations on morbidity and mortality were significantly different (p<0.05).

AFLP-based genetic diversity assessment of commercially important tea germplasm in India.

India has a large repository of important tea accessions and, therefore, plays a major role in improving production and quality of tea across the world. Using seven AFLP primer combinations, we analyzed 123 commercially important tea accessions representing major populations in India. The overall genetic similarity recorded was 51%. No significant differences were recorded in average genetic similarity among tea populations cultivated in various geographic regions (northwest 0.60, northeast and south both 0.59). UPGMA cluster analysis grouped the tea accessions according to geographic locations, with a bias toward China or Assam/Cambod types. Cluster analysis results were congruent with principal component analysis. Further, analysis of molecular variance detected a high level of genetic variation (85%) within and limited genetic variation (15%) among the populations, suggesting their origin from a similar genetic pool.

Mn-site doping and its effect on inverted hysteresis and thermomagnetic irreversibility behavior of antiferromagnetic Mn5Si3 alloy.

The structural and magnetic behavior of Mn-site doped intermetallic manganese silicide alloys of nominal compositions Mn5-x A x Si3 (x = 0.05, 0.1, 0.2 and A = Ni, Cr) have been investigated with a focus to the inverted hysteresis behavior and thermomagnetic irreversibility. Room temperature x-ray powder diffraction data confirm that all the doped alloys crystallize in hexagonal D88 type structure with space group P63/mcm. The doped alloys are found to show paramagnetic-collinear antiferromagnetic (AFM2)-noncollinear antiferromagnetic (AFM1) transitions during cooling from room temperature. A significant decrease in the critical values of both AFM1-AFM2 transition temperatures and fields have been observed with the increasing Ni/Cr concentration. Inverted hysteresis loop, field-induced arrest, and thermomagnetic arrest, the key features of the undoped Mn5Si3 alloy, are found to be significantly affected by the Mn-site doping and eventually vanishes with 4% doping.

Outcome of Single Stage Correction of High Variety of Anorectal Malformation.

The standard treatment of high variety anorectal malformation (ARM) is the staged approach. A growing interest in one stage correction of high variety ARM was noted recently. The aim of this study was to examine the feasibility, safety and outcome of single stage correction of High variety ARM. This prospective study was carried out in the Department of Paediatric Surgery, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh from July 2012 to September 2013. It was conducted among 30 patients, all having high ARM. The type of ARM was diagnosed by clinical examinations and imaging studies like Invertogram and Transperineal USG. Other associated congenital anomalies were excluded. Out of 30 patients 11(36.67%) were male and 19(63.33%) were female. The age incidence ranges from 2 days to 5 months with the mean±SD age 1.70±1.63 months. The type of fistula present along with ARM in male varies from rectobulber urethral fistula, recto prostatic urethral fistula, recto vesical fistula and in one case without any fistula. Type of fistula was rectovestibular, rectovaginal and one cloacal malformation among the female patients. The treatment modalities in male patients vary in transabdominal pull through anorectoplasty and PSARP, in which the former was done more (72.73%). In case of female patients, treatment modalities vary in transabdominal pull through and anorectoplasty and transfistulous anorectoplasty, with the later done more (52.63%). Regarding post operative complications, there was 1(14.29%) wound infection in male and 1(33.33%) in female, partial wound disruption in 1(14.29%) male patient, mucosal prolapse 2(28.57%) in male and 1(33.33%) in female, anal stenosis 1(14.29%) in male and 1(33.33%) in female, perianal soiling in 1(14.29%) male patient. All the complications were treated by adopting various measures. One stage correction of High variety ARM in both male and female patients is technically feasible. The safeties of this approach depend on the adherence to strict inclusion criteria. The early post operative complications are acceptable and can be managed successfully.

Effect of environmental iodine deficiency (EID) on foetal growth in Nigeria.

BACKGROUND & OBJECTIVES: There is scarcity of information on impact of iodine deficiency on growth and development of newborns, both pre-term and term babies. The present study was carried out to see the impact of iodine deficiency (ID) on the intrauterine foetal growth and development in terms of birth weight (BW) in an African population living in an iodine deficient zone. METHODS: The maternal and cord serum thyroid parameters at term delivery (38-40 wk of gestation) were measured and correlated with the birth weights of the corresponding newborns, and the results compared between those assessed in an ID zone (Jengere region of Bassa district, Plateau State, Nigeria) and with that of non ID (Control) zone, Jos, the State capital. RESULTS: The level of maternal and neonatal thyroid function were significantly reduced in the group with low birth weights (<2.5 kg) as compared to the level seen in normal birth weights category in both control (Jos) and ID (Jengere) regions. Both in non ID and ID regions the maternal serum thyroxine (T4), thyroxine binding globulin (TBG) and free thyroxine index (FT4I) were positively correlated (P<0.005) with BW of term babies while thyroid stimulating hormone (TSH) (P<0.005) and thyroxine binding capacity (TBK) (P<0.05) showed negative correlation. Maternal T3 and T3/T4 ratio did not show any correlation with BW in Jos, while in the ID region of Bassa the BW showed a positive correlation (P<0.005) with the maternal serum T3 and T3/T4 ratio. Cord serum analysis of the term babies revealed that the BW was positively correlated with its T4, triiodothyronine (T3), TBG, FT4I and T4/TBG ratio (Jos only) (P<0.005) in both ID region of Bassa and non ID control zone of Jos. Cord serum TSH and TBK showed negative correlation (P<0.005) with BW. Thyrotrophin releasing hormone (TRH) stimulation test revealed that mothers with small for date (SFD) babies at term were more hypothyroid compared to the level of thyroid function seen in the women delivering normal babies. INTERPRETATION & CONCLUSION: Maternal thyroid hormone plays a significant role in the intrauterine foetal growth and development, and the smaller babies and their corresponding mothers, in an ID affected area are functionally sub-thyroid in greater proportion due to prevailing long standing environmental iodine deficiency (EID). Maternal T3 is an important factor in the defence of foetus in ID regions.

The drug sensitivities of Plasmodium falciparum in the Sonitpur district, Assam, India.

Falciparum malaria is an ongoing problem in the foothills of Northeast India. Evaluation of the drug sensitivities of P. falciparum was carried out in four endemic villages of the Sonitpur District of Assam, involving 218 cases who were tested in vivo over 35 days. Chloroquine resistance was detected at the RI level in 29 cases (13%) and RII level in 8 cases (4%). No RIII chloroquine resistant cases were detected in the study. RI resistance was observed in the age groups 6-10 years, 11-14 years, and 15 years and above in 16%, 17%, and 13%, respectively. RII level resistance was observed in 4% of all those groups combined. All the RI and RII resistant cases responded well to a single dosage of Metakelfin (sulfamethoxypyrazine I.P 1,500 mg and pyrimethamine I.P 75 mg).

Improved technique for transient expression and negative strand virus rescue using fowlpox T7 recombinant virus in mammalian cells.

The suitability of recombinant T7 polymerase produced using either the highly attenuated MVA strain of vaccinia (MVA-T7) or fowlpox virus (FP-T7) for transient expression and negative strand virus rescue was compared in two mammalian cell lines (MDBK and Vero) and in primary cells of bovine, ovine and caprine origin. Such primary cells are more permissive for the growth of wild type strains of morbilliviruses, such as Rinderpest virus and Peste des petits ruminants virus. MVA-T7 was found to be highly cytopathic in the primary cells, multiplying rapidly and killing the cells within 3-5 days of infection, even when very low multiplicities of infection (MOI) were used. In contrast, FP-T7, which appeared to express similar amounts of T7 polymerase, was found to be non-cytopathic in a variety of primary and established cell lines of mammalian origin and was suitable for use in virus rescue experiments. MDBK cells and primary cells, unlike Vero cells, could not be efficiently transfected and so were unsuitable for virus rescue. Optimal conditions for rinderpest virus rescue in Vero cells were established using FP-T7 in place of MVA-T7. This system will be suitable for rescuing other viruses which grow in Vero cells.

Diclofenac sodium injection sterilized by autoclave and the occurrence of cyclic reaction producing a small amount of impurity.

A known impurity is formed in the production of a parenteral dosage form of diclofenac sodium if terminally sterilized by autoclave. This impurity has been detected as 1-(2,6-dichlorophenyl) indolin-2qone, which is also an intermediate from which diclofenac sodium is generally synthesized. It is only the condition of the autoclave method (i.e., 123 +/- 2 degrees C) that enforces the intramolecular cyclic reaction of diclofenac sodium forming the indolinone derivative and sodium hydroxide. The formation of this impurity has been found to depend on the initial pH of the formulation. The reaction follows first-order kinetics, and the energy of activation is 5.34 kcal/mol. The other excipients in the formulation do not have a role in this reaction. The concentration of the impurity in the resultant product in the ampule goes beyond the limit of the raw materials in the pharmacopoeias. It is thus preferable to use an alternative sterilization method; that is, an aseptic filtration method in which the formation of this impurity can be avoided.

Effect of growth medium on hydrophobicity of Staphylococcus epidermidis.

The present study was undertaken to evaluate the effect of growth medium on expression of hydrophobicity of Staphylococcus epidermidis. A total of 24 hydrophobic isolates of S. epidermidis, determined by n-hexadecane adherence assay (HAA) earlier were included. Five different growth media: horse blood agar (HBA), brain heart infusion agar (BHIA), brain heart infusion broth (BHIB), tryptic soy broth (TSB) and proteose peptone broth (PPB) were used. All 24 isolates exhibited the reproducible hydrophobicity when grown on HBA; however, 20 (83.33%), 19 (79.16%), 15 (62.50%) and 13 (54.16%) isolates were found to be hydrophobic when grown in BHIA, BHIB, TSB and PPB, respectively. HBA was found to be the most suitable medium for detection of hydrophobicity of S. epidermidis followed by BHIA or BHIB.

Comparative evaluation of hydrophobicity measures for virulence determination of Staphylococcus epidermidis from hospitalized patients & healthy individuals.

BACKGROUND & OBJECTIVES: Hydrophobicity is one of the recognized markers for identifying pathogenic strains of Staphylococcus epidermidis. A number of tests are available for measuring the hydrophobic character but three tests viz., salt aggregation test (SAT), n-hexadecane adherence assay (HAA) and xylene adherence assay (XAA) are in common practice with different degrees of sensitivity. However, in the Indian context, no systematic study has been reported on the hydrophobicity of S. epidermidis. Hence, the present study was undertaken to compare the three methods for hydrophobicity measurement for identifying the pathogenic isolates of S. epidermidis. METHODS: Of the 597 samples obtained from milker's and butcher's (hand and nose), hospitalized pre-operative patients (hand, nose, ear), and post-operative patients (blood) examined, 212 isolates of S. epidermidis were recovered using established laboratory procedures. The isolates were screened by the three tests viz., SAT, HAA and XAA. The identified hydrophobic isolates were further tested by mouse inoculation method. RESULTS: Of the 212 S. epidermidis isolates studied, 24 (11.32%), 23 (10.84%) and 4 (1.88%) were found to be hydrophobic as detected by HAA, XAA and SAT, respectively. No isolates from apparently healthy individuals were found to be hydrophobic by SAT while 13 (8.76%) and 10 (8.24%) strains from apparently healthy individuals were detected to be hydrophobic by HAA and XAA, respectively. Seven (33.38%) isolates each were hydrophobic by HAA and XAA and 4 (22.22%) by SAT among the isolates from hospitalized post-operative patients. INTERPRETATION & CONCLUSION: The results suggested that there was no difference in the number of strains detected as hydrophobic by HAA and XAA, and any of the two tests may be used for screening the hydrophobic strains of S. epidermidis from healthy individuals and patients.

Persistence of leech repellents on cloth.

Trials on persistence of repellent properties of N, N-diethyl phenyl acetamide (DEPA), N,N-diethyl-m-toluamide (DEET), 3acetyl2(2-6-dimethyl-5-heptenyl)oxazolidine(Citronyl) , dimethyl phthalate (DMP) and N-benzoyl piperidine (NBP) on cloth were conducted against land leeches in evergreen rain and deciduous forests of Assam. Results obtained were compared with volatile oil of Zanthoxylum armatum DC. syn. Z. alatum Roxb (Timur) to evaluate its efficacy as leech repellent. DEPA and DEET were found to be the best. Timur oil was at par with Citronyl and exhibited better results than DMP and NBP.

Shiga toxin producing Escherichia coli infection: current progress & future challenges.

Shiga toxin producing Escherichia coli (STEC) is a newly emerged pathogen that has been the focus of immense international research effort driven by its recognition as a major cause of large scale epidemics and thousands of sporadic cases of gastrointestinal illness. It produces a severe bloody diarrhoea that is clinically distinct from other types of diarrhoeal diseases caused by other enteric pathogens. One of the most important areas of current exploration concerns how STEC enters our food chain, an investigational avenue that begins with the ecology of STEC in animals and in the environment. A variety of foods have been identified as vehicles of STEC-associated illness and this makes the organism one of the most serious threats to the food industry in recent years. The pathogenesis of STEC is multifactorial and involves several levels of interaction between the bacterium and the host. STEC strains carry a set of virulence genes that encode the factors for attachment to host cells, elaboration of effective molecules and production of two different types of Shiga toxins. These genes are found in the locus of enterocyte effacement (LEE), lamboid phages, and a large virulence associated plasmid. The publication of the complete genome sequence of Esch. coli O157:H7 chromosome offers a unique resource that will help to identify additional virulence genes, to develop better methods of strain detection and in the understanding of the evolution of Esch. coli through comparison with the genome of the non-pathogenic laboratory strain Esch. coli K-12. These research efforts in turn, should lead to development of new potent and cost effective anti-Stx therapies or vaccines and thereby major improvement in human health world-wide.

Anticonceptive and estrogenic effects of a seed extract of Ricinus communis var. minor.

An ether-soluble fraction of a methanol extract of Ricinus communis var. minor seeds administered subcutaneously to adult female rats and rabbits at doses up to 1.2 g/kg and 600 mg/kg, respectively, in divided doses showed anti-implantation and anticonceptive activities. Laparotomy performed on Day 10 and Day 15 of pregnancy on mated female rats and rabbits treated with the extract did not reveal any uterine implantation sites. The animals were protected against pregnancy for over three gestation periods and among those that later delivered, there was no evidence of abnormality in the pups. In ovariectomized young female rats as well as in immature mice, the extract dose-dependently increased uterine wet weight. Furthermore, the extract induced premature opening of the vagina, increased the number of epithelial cells and cornified cells and decreased the leucocyte number in the vaginal smear. The estrogen-like activities exhibited by the extract were dose-dependent and the anticonceptive effect may be due at least in part to such estrogenic action.

Field trial of Abate and Teknar for Simulium (Diptera: Simuliidae) control in India.

Simulium breeding was eliminated in a river up to 30 km with 0.1 ppm Abate (temephos) for 30 min exposure. Teknar (Bacillus thuringiensis var. israelensis) at 10 ppm for 10 min exposure resulted in 98.4% and 87.9% reduction up to 20 m in 2 sections of a small stream.

Epidemiological and entomological aspects of malaria in forest-fringed villages of Sonitpur district, Assam.

BACKGROUND & OBJECTIVES: Detailed epidemiological and entomological studies were undertaken in forest-fringed villages and a Tea Estate in Sonitpur, Assam to assess the malaria situation. METHODS: Door-to-door active surveillance was carried out to collect blood samples. Thick and thin blood smears stained with Giemsa were used for malaria parasite detection. Mosquito collections were made using CDC miniature light-traps and hand catch methods from dusk-to-dawn. RESULTS: 48% SPR, 49.1 Pf% was recorded from the study villages. Children between 10 and 14 years were most sufferers. Per trap night density of mosquitoes in human dwellings was 204.3 and in cattlesheds--908.7, An. minimus accounted for 20.7% of total malaria vectors. INTERPRETATION & CONCLUSION: The results showed high malaria risk in the study villages. High vector density with high parity rate, poor socio-economic conditions, lack of awareness, poor sanitation and congenial atmosphere for mosquito proliferation are aggravating the malaria situation more complex in the study area.