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Erectile Dysfunction (ED) describes the persistent inability to achieve or maintain a penile erection for adequate sexual performance. ED is thought to be a vascular disease affecting more than 70% of men with (Cardiovascular Disease) CVD and sharing a myriad of risk factors like hypertension, smoking, diabetes, obesity, ageing and the metabolic syndrome. Diabetes increases the risk of both ED and CVD with the latter being the leading cause of death. Endothelial dysfunction and its role in the development of atherosclerosis may be the common link between ED, CVD and diabetes. With the current epidemic of type 2 diabetes, diabetes related CVD will increase in tandem. Early identification of this risk group is therefore paramount. Evidence has shown that ED is an independent marker of increased CVD risk and heralds the onset of coronary artery disease, peripheral arterial disease and stroke thereby providing a window of opportunity for risk factor modification. In our paper we shall explore the correlation of ED and CVD with a view to formulation of intervention strategies. Chatt Maa Shi Hosp Med Coll J; Vol.18 (2); July 2019; Page 59-66

Thiopurine methyltransferase (TPMT) enzymes play a crucial role in azathioprine metabolism. Mutations in the enzyme initiate generation of excess thioguanine, which causes suppression of various cell lineages. The objectives of this study were to investigate the prevalence of TPMT mutation in Bangladeshi patients with systemic lupus erythematosus (SLE) requiring azathioprine therapy and its relation to the development of myelosuppression. 250 patients with SLE were enrolled, then monitored for myelosuppression adverse events for 4 months. TPMT*3C (rs1142345), TPMT*3B (rs1800460), and TPMT*2 (rs1800462) polymorphisms were analyzed using polymerase chain reaction–restriction fragment length polymorphism. The risk of myelosuppression (i.e., leukopenia, thrombocytopenia, and anemia) was estimated as the odds ratio (OR) with 95% confidence intervals (CIs) and p values. Of the 250 patients, 17 (6.8%) were heterozygous for the TPMT*3 mutation and 233 (93.2%) were homozygous for the wild type; no patients carried a homozygous mutation. Grade III/IV leukopenia, thrombocytopenia, and anemia occurred in 12.0%, 12.0%, and 27.9% of wild-type TPMT patients respectively; corresponding rates in heterozygous TPMT*3C patients were 70.6%, 64.7%, and 5.9%. Patients with Grade III/IV azathioprine-induced leukopenia were significantly more likely to have the heterozygous TPMT*3C genotype than the wild-type variant (OR 17.6; 95% CI 5.8–53.6; p

Genetic resistance is a successful strategy for management of clubroot (Plasmodiophora brassicae) of brassica crops, but resistance can break down quickly. Identification of novel sources of resistance is especially important when new pathotypes arise. In the current study, the reaction of 177 accessions of Brassica napus to four new, virulent pathotypes of P. brassicae was assessed. Each accession was genotyped using genotyping by sequencing to identify and map novel sources of clubroot resistance using mixed linear model (MLM) analysis. The majority of accessions were highly susceptible (70–100 DSI), but a few accessions exhibited strong resistance (0–20 DSI) to pathotypes 5X (21 accessions), 3A (8), 2B (7), and 3D (15), based on the Canadian Clubroot Differential system. In total, 301,753 SNPs were mapped to 19 chromosomes. Population structure analysis indicated that the 177 accessions belong to seven major populations. SNPs were associated with resistance to each pathotype using MLM. In total, 13 important SNP loci were identified, with 9 SNPs mapped to the A-genome and 4 to the C-genome. The SNPs were associated with resistance to pathotypes 5X (2 SNPs), 3A (4), 2B (5) and 3D (6). A Blast search of 1.6 Mb upstream and downstream from each SNP identified 13 disease-resistance genes or domains. The distance between a SNP locus and the nearest resistance gene ranged from 0.04 to 0.74 Mb. The resistant lines and SNP markers identified in this study can be used to breed for resistance to the most prevalent new pathotypes of P. brassicae in Canada.

Genetic resistance is widely used to manage clubroot (Plasmodiophora brassicae) in brassica crops, but new pathotypes have recently been identified on canola (Brassica napus) on the Canadian prairies. Resistance effective against both the most prevalent pathotype (3H, based on the Canadian Clubroot Differential system) and the new pathotypes is needed. BC1 plants of Brassica rapa from a cross of line 96-6990-2 (clubroot resistance originating from turnip cultivar &lsquo, Waaslander&rsquo, ) and a susceptible doubled-haploid line, ACDC, exhibited a 1:1 segregation for resistance against pathotypes 3H and 5X. A resistance gene designated as Rcr3 was mapped initially based on the percentage of polymorphic variants using bulked segregant RNA sequencing (BSR-Seq) and further mapped using Kompetitive Allele Specific PCR. DNA variants were identified by assembling short reads against a reference genome of B. rapa. Rcr3 was mapped into chromosome A08. It was flanked by single nucleotide polymorphisms (SNP) markers (A90_A08_SNP_M12 and M16) between 10.00 and 10.23 Mb, in an interval of 231.6 Kb. There were 32 genes in the Rcr3 interval. Three genes (Bra020951, Bra020974, and Bra020979) were annotated with disease resistance mechanisms, which are potential candidates for Rcr3. Another resistance gene, designated as Rcr9wa, for resistance to pathotype 5X was mapped, with the flanking markers (A90_A08_SNP_M28 and M79) between 10.85 and 11.17 Mb using the SNP sites identified through BSR-Seq for Rcr3. There were 44 genes in the Rcr9wa interval, three of which (Bra020827, Bra020828, Bra020814) were annotated as immune-system-process related genes, which are potential candidates for Rcr9wa.

Cervical carcinoma is a preventable condition and over 95% of patients with early carcinoma cervix can be cured. But still women dying from malignant disease of all kinds the cervix is the common organ primarily involved. The study was conducted to find out the predisposing factors of carcinoma cervix in our population and to scrutinize the patients in early stages, so that measures can be taken to prevent it. After approval of ethical committee and informed written consent fifty patients from Dhaka Medical College hospital were included in this study from January 2003 to December 2003. Among the 50 patients 36 were between 31to 50 years, 42 patients present with blood stained per vaginal discharge and 40 present with post-coital bleeding. Regarding identifiable risk factors early age of 1st intercourse was most common followed by multiparity. Ninety four percent of patients had squamous cell carcinoma and reminder were adenocarcinoma. Incidence of carcinoma cervix can be decreased by health education with special attention to risk factors and morbidity and mortality can be reduced by detection of cases in early stage when it is still curable.J Bangladesh Coll Phys Surg 2017; 35(3): 110-114

Background: Acute acalculous cholecystitis (AAC) is traditionally known to occur in critically ill patients, following cardiac surgery, abdominal vascular surgery, severe trauma, burns, prolonged fasting, total parenteral nutrition, or sepsis, and is believed to have a worse prognosis as compared with acute cholecystitis associated with stones. Our observation of de novo presentation of AAC in several outpatients in the absence of critical illness or predisposing factors prompted us to undertake this study. The aims of the present study were to examine the prevalence of AAC patients in the outpatient setting in our hospital, to identify associated risk factors and to assess the clinical course and outcome of these patients. Patients and methods: All patients who had a cholecystectomy (laparoscopic or open surgery) for acute cholecystitis at National University Hospital from January 2001 to May 2005 were reviewed from a prospectively maintained database. The demographic characteristics, clinicopathologic features, operative parameters, postoperative course, and histopathology of the patients were reviewed. Results: Eleven of 133 patients with acute cholecystitis fulfilled the criteria for the diagnosis of AAC. Patients’ ages ranged from 30 to 69 years (mean 52.39 years). All these patients presented as outpatients. None of the patients had any critical illness predisposing to AAC. The mean age was slightly less in the AAC group as compared with the remaining patients with acute cholecystitis (52.39 years vs 55.22 years, p=0.54). There was male predominance in the AAC group (male:female = 9:2). The time from admission to surgery, operative procedure, operative time, and postoperative stay were not statistically different from the remaining patients with acute cholecystitis. Discussion: AAC can occur in young and middle-aged healthy individuals, the presentation is no different from acute calculous cholecystitis, the prognosis is good if diagnosed and treated early.

Arsenic is listed as a hazardous material and is a suspect carcinogen, reportedly responsible for lung and skin cancers. It is also a teratogen, which means that it is capable of crossing the placental membrane into the metabolic system of unborn children. The level of arsenic allowed in drinking water has been set at 0.01 mg/l by the World Health Organization (WHO). However, the maximum permissible limit of arsenic in drinking water of Bangladesh is 0.05 mg/l. The actual toxicity of arsenic to the human body varies depending on several factors as general health and diet. It is a cumulative substance, which slowly passes out of the body through urine, hair, fingernails/toenails and skin. In Bangladesh, most of the recognized stages of arsenic poisoning have been identified. The risk of arsenic poisoning in Bangladesh is increasing. The number of patients seriously affected by arsenic in drinking water has now risen to 7000 demanding extensive research in this field. This note addresses tubewell contamination in groundwater and health-related impacts. A previous study made by the author presents the subsurface occurrence of arsenic and the reason of contamination. The latest statistics available on the arsenic contamination in groundwater indicate that 52 districts around 80% of the total area of Bangladesh and estimate that around 40 million people are at risk. Patients with melanosis, leuco-melanosis, keratosis, hyperkeratosis, dorsum, non-petting oedema, gangrene and skin cancer have been identified. Among the affected people, the most common presentations are melanosis (93.5%), keratosis (68.3%), hyperkeratosis (37.6%) and dipigmentation (leuco-melanosis) (39.1%). Cancers were found among 0.8% and actinic keratitis and Bowen's disease are identified among 3.1% cases. According to available data the Dhaka Community Hospital (DCH) identified 1903 patients with arsenical skin manifestations, the National Institute for Preventive and Social Medicine (NIPSOM) listed 800 arsenicosis patients and the Institute for Post-Graduate Medical Research (IPGMR) investigated 250 arsenical skin lessions patients.

Both soil and underground water of the southwestern Bangladesh has already been threatened with arsenic contamination affecting health of millions of people. An estimated 44% of total area of Bangladesh (34 districts) and 53 million rural people are at risk of arsenic poisoning. In the southwestern and some parts of eastern Bangladesh, arsenic content in soil and underground water has identified higher contamination. The experts at Bangladesh Council for Scientific and Industrial Research (BCSIR) found the highest contamination, 14mg/l of shallow tube well water in Pabna, a northern district and 220mg/kg of soil in Sylhet area of Bangladesh. The World Health Organization (WHO) standard for arsenic in drinking water is 0.01mg/l . However, the maximum permissible limit of arsenic in drinking water of Bangladesh is 0.05mg/l. Worsening contamination of groundwater aquifer and sufferings of the millions of people demand extensive research in this field.This study is a preliminary evaluation of our ongoing research on current state of the subsurface contamination of arsenic in Bangladesh. Last decade water resources management has been analyzed to cope with the problem in the source level. Possible geo-hydrological and geo-chemical occurrences of arsenic in subsurface are discussed. The concentration of arsenic and the stratigraphic occurrence are presented. It is observed that arsenic concentration in tubewell water of 31 districts of Bangladesh contain above the maximum permissible limit. And the concentration of arsenic in tubewell water decreases with the depth of subsurface.

doi: 10.3329/jcmcta.v18i1.3818Journal of Chittagong Medical College Teachers' Association 2007: 18(1):29-31