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Introduction: Angiotensin converting enzyme 2 (ACE2) is expressed in several cell types in the body including the gastrointestinal (GI) epithelium. Objective:To provide an overview of the normal distribution of ACE2 in the GI tract, altered ACE2 expression notably in coronavirus infection and its consequences. Materials and Methods: Pubmed and google scholar were searched using the key words ACE2 paired with GI tract, intestinal permeabilty, gut microbiota, inflammatory bowel disease. Results and Discussion: ACE2 is highly expressed in the ileum and colon in human being as well as in rodents. In this current situation of COVID-19 pandemic, downregulation of ACE2 has been reported due to internalization of the ACE2-virus complex within the cells. Although researches are still in infancy in this topic, altered luminal microbiota, increased intestinal permeability, higher level of inflammatory markers and deficient nutrient transport has been reported due to altered ACE2 expression. Conclusion:Altered expression of ACE2 has the possibility to hamper normal physiological function of the GI tract and might affect GI disease progression and prognosis. Bangladesh Journal of Medical Science Vol. 21 No. 04 October’22 Page : 808-812

In forensic medicine, there can be times when the dilemma of having to choose between harvesting organs from cadaveric donors versus the need to complete the forensic analysis to savor the equally important forensic outcomes becomes tricky as well cul de sac of one on another. The deliberation of the seemingly practical junction is of academic value and ethical considerations that need to be dissected upon. As such, the impacts of forensic outcomes on cadaveric organ donations in Malaysia through the lenses of (i) academic benefits of forensic outcomes, (ii) ethically justified considerations of the dilemma, and (iii) available data helpful in navigating through the two competing needs.

Background: The present study aims to measure the circumference, length, and breadth of thedifferent leaflets of the tricuspid valve orifice in men and women to enable improved treatmentand management for cardiac patients in future. Materials and methods: In this cross-sectionalstudy, samples of the cadaveric heart (41 male, 19 female, and age ranging between 20 and70 years) were collected within 12–24 hours of death from unclaimed dead bodies that wereautopsied in the morgues of Sir Salimullah Medical College (SSMC) and Dhaka Medical College(DMC), Dhaka, Bangladesh. Unpaired t-test was conducted to determine significant genderdifferences using SPSS 16. Results: There were no significant difference in the circumference,length, and breadth of the anterior, posterior, and septal leaflets of tricuspid valves between menand women. Conclusion :The circumference, length, and breadth of the anterior, posterior,and septal leaflets of tricuspid valves are similar between men and women in the Bangladeshipopulation. Therefore, there will be no specific difference in the surgical and therapeutictreatment for men and women. Bangladesh Journal of Medical Science Vol.20(2) 2021 p.342-347

Medical negligence cases in Malaysia are not far behind from other developed countries in terms of quantity and costs. The challenges of medical negligence in Malaysia have always been an enemy to both patients and doctors. Both parties may lose more than they gain from the adversarial adventure of medical litigation. Hence prevention of medical negligence is the best effort in ensuring the best medical practice for both parties. Practicing ethical medical practice and improving communication with the patient is some of the methods to avoid getting sued. If this fails, alternatives to medical litigation such as alternative dispute resolution in the form of mediation and no-fault compensation scheme. These alternatives may offer more to both parties rather than going through the litigation process.

Digital autopsy is the future of postmortem examination of the human body through digital visualization. Imaging modalities such as CT scanners and MRI scanners use X rays and magnetic fields to visualize the structures within the human body. The outputs from these modalities are obtained in a DICOM (Digital Imaging and Communications of Medicine) format. They are in gray-scale consisting of information in every slice taken during the scan. This is rendered and visualized as the full body in a digital format during the digital autopsy procedure. The visualization rendering produces a three-dimensional body, further presented in colour format based on each structure of the human organ system. Digital autopsy is a technology which allows pathologists to navigate and explore deeper into the human body. It allows analysis to be done in both two-dimensional and three dimensional perspectives. Digital autopsy involves analysis of human pathology and anatomical findings for diagnostic purposes. It can also be used for education and research purposes. Another advantage of digital autopsy is the availability of information and data that can be easily and securely transferred to a different digital autopsy facility at a different location. Thus, digital autopsy provides an efficient, fast, cheaper and accurate post-mortem data enabling a forensic pathologists to play a more effective role in the criminal justice system.

Reporting a case of natural death where blind anti-tubercular treatment started late due to atypical presentation and conflicting laboratory reports.The deceased was a 25 year old male Indonesian rubber plantation worker initially diagnosed as Crytococcal infection and had been treated on antifungal regime. Histological examination of various organs after post mortem examinations revealed disseminated tuberculosis. DOI: http://dx.doi.org/10.3329/jafmc.v10i1.22936 Journal of Armed Forces Medical College Bangladesh Vol.10(1) 2014

A small amount of Methamphetamine (MA) can produce behavioural changes such as euphoria, increased alertness, paranoia, decreased appetite and increased physical activity. In cardiovascular system, it can produce chest pain and hypertension which can result in cardiovascular collapse. In addition, MA causes accelerated heartbeat, elevated blood pressure. It can also cause irreversible damage to blood vessels in the brain. A number of sympathomimetic amines are capable of causing myocardial damage, but the cardio-toxic action of MA has been of particular interest since standardized dosage consistently produces myocardial lesions. As this drug is a choice of many teenagers and young adults, the damage to their health, as well as their future aspects could be greatly affected, therefore more evidence must be sought to convince them the negative root and show them the optimism of recovery and salvation. To clarify the effect of Methamphetamine (MA) on myocardium, 56 male Wister rats aged four weeks were divided equally into MA, Methamphetamine withdrawal (MW), Placebo (P) and Control (C) group were examined following daily intra-peritoneal administration of MA at a dose of 5 mg/kg body weight for 2, 4, 8 and 12 weeks. Normal saline was similarly injected in P group. Light microscopic changes was seen in the myocardium of MA treated group including eosinophilic degeneration, atrophy, hypertrophy, disarray, edema, cellular infiltration, myolysis, granulation tissue, fibrosis and vacuolization. On the other hand, the withdrawal group showed evidence of gradual recovery of those myocardial changes. Optimism is therefore generated about possibility of returning towards normal by withdrawing of this drug by the addicts.

Samoa, considered the heart of Polynesia, has a medicolegal system with some limitations. There is a need to build a well-organized medicolegal service. The authors briefly outline the medicolegal system in Samoa from its beginning to the present and discuss future improvements.

A sensitive method for simultaneous determination of ester-type local anesthetic drugs (procaine, tetracaine, and T-caine) has been developed using wide-bore capillary gas chromatography with nitrogen-phosphorus detection (GC-NPD). The extraction procedure, the experimental conditions for heptafluorobutyryl (HFB) derivative formation, and the percentage of the ester-type local anesthetic drugs from the human serum are described. The HFB derivatives of ester-type local anesthetic drugs showed sensitivity of approximately 2-3 fold higher than that without derivatization. The detection limits of HFB derivatives of the ester-type local anesthetic drugs were approximately 60-70 pg on column. Recoveries from the human serum were 85-94%. This method could be used to determine concentrations as low as 24-28 ng/mliters of the ester-type local anesthetic drugs.

Methamphetamine (MA) abuse is one of the challenging problems in Forensic Pathology. It has adverse effects on heart, intestine and male reproductive system. In 1990’s it was identified as an alarming problems among the adolescents. Thus the agent was included as a controlled substance. This has created two main problems. In one hand, the scientists engaged in research in this field have failed to carry forward their research projects due to scarcity of the substance. On the other hand, plenty of this substance is illegally manufactured and available in the black market especially at the border area. The article explains the current situation of MA abuse and health conditions after withdrawal of the agent.

Amplification of the human dopamine transporter gene (DAT1) was performed by the polymerase chain reaction, and polymorphism of the VNTR locus was analyzed in a population sample of 176 randomly selected Japanese individuals. Genomic DNAs were extracted from whole blood, and the 3’ untranslated region of the human DAT1 gene was amplified. The amplification products were distinguished by agarose gel electrophoresis, and visualized directly by ethidium bromide staining. In this way, four alleles were visualized directly and designated A, B, C, and D in decreasing order according to size. The relative frequencies of DAT1 alleles A through D were 0.0171, 0.0625, 0.9119, and 0.0085, respectively. Evidence of significant deviations from the Hardy-Weinberg equilibrium was observed from these Japanese population data. The DAT1 locus was estimated to have a heterozygosity index of 13 % and polymorphic information content of 0.16.

In this paper, we discuss the current medico-legal practice and future plan to improve the medico-legal service of Bangladesh which is rooted in the remnants of British medical jurisprudence. It includes clinical forensic medicine and forensic pathology. In Bangladesh all unnatural deaths are to be reported at the nearest police station and an appointed police officer should visit the scene of crime for investigation and to arrange postmortem if required. The forensic services of the country are delivered partly by academic staffs of Government Medical Colleges and the rest by the Civil Surgeons. Sometimes, residential medical officers in the district hospitals perform the medico-legal work. Most of them have no forensic qualifications except a long exposure in the medico-legal field. Currently academic and professional postgraduate courses are available. The chemical examiner's laboratory is situated at Dhaka with the facility of quantitative tests only. The Government of Bangladesh is trying to standardize the existing system. A Workshop on medico-legal services has been organized regularly by The Medico-legal Society of Bangladesh. A DNA profiling laboratory at the Dhaka Medical College is in the process of being set up. Such progress will be a milestone in the development of the medico-legal service in Bangladesh. However, with a few exceptions, teaching and training facilities are still lacking.

This paper investigates the pattern of autopsy findings in the Forensic Medicine Department of Sir Salimullah Medical College, Dhaka, Bangladesh. We examined 2534 autopsy reports that were carried out over a period of 10 years from January 1, 1988 to December 31, 1997. Findings have been presented in the aggregate as well as by gender and the manner of death. The manner of death is categorized into four groups: homicide, suicide, accident and natural. We have also included negative autopsies and undecided cases as separate categories. In our study period, 73% of the cases were male. Total growth of autopsy rates in male and female were 7 and 5%, respectively. In terms of incidence most autopsy cases related to accidents (37%), followed by homicide (21%) and suicide (18%). There were numerous problems with chemical reports that led to undue delay in disbursement of justice. In many cases autopsy findings remained undecided because the manner of death could not be determined due to lack of coordination between the forensic doctors and the legal authorities. Undecided and negative autopsy cases were increasing at a very high rate.

© 2012 Khan and Nasimul Islam , licensee InTech. This is an open access chapter distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Morphology of the Intestinal Barrier in Different Physiological and Pathological Conditions

The allele distributions of the STR locus D20S161 have been investigated in Japanese and Bangladeshi people. No deviation from the Hardy-Weinberg equilibrium was observed in either population. D20S161 was found to be a polymorphic STR with seven alleles in Japanese and with six alleles in Bangladeshi. The distribution of allele frequencies in Japanese was very similar to that in Bangladeshi. The D20S161 system can be a potential marker for medicolegal individualization and paternity testing.

Series of experiments have been completed with Methamphetamine (MA). Some were with the higher, medium or lower duration of MA administration and some were with acute or chronic doses. Whatever may be the dose or duration the ultimate result came out with the further establishment of cardio-toxic effect of this drug. Cardiovascular symptoms related to MA toxicity include chest pain, palpitations, dyspnoea, hypertension, tachycardia, atrial and ventricular arrhythmias, and myocardial ischemia. MA abusers often go through a repeated pattern of frequent drug administrations followed by a period of abstinence. Previous studies have focused largely upon the chronic effect of MA intake to major organs, such as the brains and the heart, by using animal experiments. However, there is a lack of research into the effects of acute dose of MA, especially pertaining to the heart. To clarify the effect of MA on myocardium, 22 male Wister rats aged six weeks were divided into MA, Placebo (P) and Control (C) group were examined following single intraperitoneal administration of MA at a dose of 50 mg/kg body weight. Normal saline was similarly injected in P group. Light microscopic changes was seen in the myocardium of MA treated group including cellular infiltration, with clusters of macrophage-like cells having large nuclei and little cytoplasm evident in the sub-endocardium region. There were presence of few macrophages, leucocytes, and spindle-like fibroblasts. Bringing in to account of cardiac changes by a single dose of MA, slogan should be voiced out to leave methamphetamine.

This paper investigates the pattern of sexual offence cases attended at the One Stop Crisis Center (OSCC) of the Accident and Emergency Department, Hospital Universiti Sains Malaysia (HUSM), Kelantan. A total of 439 reported sexual offence cases were examined over a period of 4 years from 2000 to 2003. Sexual offence constituted by male partner or boyfriend in 18.9%, by relatives in 27.3% and by “others” in 53.8% of cases. Only 0.7% of victims did not attempt to lodge a police report. There is a significant relationship between occupation and the risk of experiencing sexual violence. Students were mostly targeted by the perpetrator throughout the study period. Among the offences, rape cases were the highest in number, among those who attended at the OSCC, HUSM with a total of 72.7%; followed by 27.3% of incest; 26.4% of child sexual abuse; 4.8% of sodomy and lastly 1.6% of gerontophilia cases. Only 70% of the specimens obtained from sexual offences victims were sent for laboratory analysis. The result remained negative in 82.4% specimens and thus the laboratory analysis result is merely functioning as a supportive evidence for sexual offence cases attended at OSCC. The studies showed that most of the sexual assault perpetrators were known to the victims. The place of crime was also known to the perpetrators. Health sectors of various levels should be working in conjunction to promote a societal changes to improve more of the women’s right and thus to reduce the violence crime.

Sexual assault is one of the fast growing violent crimes in Bangladesh. We carried out a retrospective study of 675 alleged rape victims out of total examined 1665 cases during 1994-2000. In the last seven years, 441 victims refused examination and a final report is pending in 2.4% cases due to non-availability of ancillary investigation reports. We found that 48.9% cases were sexually abused based on history, physical evidence and opinion of the examining doctor although high vaginal swab for spermatozoa was found to be negative in all cases. Out of 675 cases studied in this paper, 33.5% was in the 12-15 year age group, in 511 cases the assailant was known to the victims, 23.7% was reported and was examined within 72 h of occurrence, unmarried persons constituted 56.6% cases and 69.9% was literate. In 45.8% of the cases the victims were abused during the daytime. Non-genital violence was observed in 91 cases, 2.9% was admitted to the hospital, 2% reported with pregnancy, 0.4% reported with abortion and four cases had a history of previous abuse. Genital findings included hymenal rupture in 38.9% and 9.6% cases of forchette were found with recent tears. In 248 cases, opinion was negative due to delayed attendance, false charge and time-consuming procedures.

Prevalence of obesity is increasing worldwide. One of the major risk factors for obesity is consumption of high fat diet (HFD). Gastrointestinal tract (GIT) is the first organ where HFD comes in contact with the body. But, the effect of HFD on the GIT especially the GIT barrier is not investigated properly. M cells are present in the Follicle associated epithelium (FAE) of Peyer’s patches (PP) of GIT and are important component of intestinal barrier. Healthy and adequate number of M cells is important for an effective intestinal barrier. Intestinal tight junction protein Claudin 4, situated in between the enterocytes of Peyer’s patches (PP), regulates the permeability through the intestinal mucosa. Reduced Claudin 4 is responsible for increased paracellular transport of antigenic materials. Calprotectin is an inflammatory marker secreted by neutrophils during inflammation. Its level is considered specific for intestinal inflammation. The objectives of this study were to investigate the expressions of M cells and Claudin 4 in the PP and to determine the fecal calprotectin level (FCP) of male Wistar rats fed HFD. Four weeks old, twenty male Wistar rats were divided into chow (n=10) and HFD (n=10) groups. After 6 weeks of consuming the respective diets, stool and GIT segments containing PP were collected. After tissue processing, tissues were sectioned into 3 micrometer thickness and were taken on poly-L-lysine coated glass slides. Immunohistochemical staining was done by rat M cell specific CK-8 antibody and anti-Claudin 4 antibody. Scoring was done to calculate the average number of M cells and Claudin 4 in the PP of both groups under light microscope. FCP were measured using a commercial enzyme linked immunoassay (ELISA) kit. Statistical analysis was done by chi-square test and independent T-test. Data are presented as mean ± SD. A p value

The human secretor α(1,2) fucosyltransferase encoded by the FUT2 determines the production of ABO(H) antigens in secretions. Recent studies demonstrated the presence of several nonfunctional alleles in the FUT2. During the analysis for inactivating mutations at the FUT2 locus from 24 Samoan and 47 Bangladeshi individuals, we found two distinct Alu-mediated deletions of FUT2. The FUT2 deletion in a Bangladeshi population was identical with that found in Indian individuals with the Bombay phenotype (sedel), but not associated with the null allele (T725G) of the H gene (FUT1). The FUT2 deletion in Samoans is a novel null allele (sedel2). The junction region of sedel2 was successfully amplified using the same primers for the sedel amplification. DNA sequencing of the junction region of the sedel2 indicated that there was a 32-bp sequence identity between DNA sequences surrounding the 5′ and 3′ breakpoints. The size of the deletion of the sedel2 was 9.3 kb, including the full coding region of FUT2. The frequency of the sedel in a Bangladeshi population was 0.074, and that of the sedel2 in a Samoan population was 0.104. Hum Mutat 16:274, 2000. © 2000 Wiley-Liss, Inc.

We investigated the cardiotoxic effects of cocaine and cocaethylene on the Ca 2+ flux responsible for excitation-contraction coupling in isolated ventricular rat myocytes. We simultaneously measured intracellular Ca 2+ transients and cell length in isolated cardiac myocytes loaded with a fluorescent Ca 2+ indicator, indo-1, during electrical field stimulation at 1 Hz. The cell length was estimated by video dimension analysis. We also measured the activities of Ca 2+ ATPase and Ca 2+ release channels of cardiac sarcoplasmic reticulum membrane vesicles. Both cocaine and cocaethylene produced significant decreases in both peak intracellular Ca 2+ and the cell-contraction rate in a dose-dependent manner. The K 0.5 for the reduction of peak intracellular Ca 2+ was 157.5 μM for cocaine, but 90.0 μM for cocaethylene. Both cocaethylene and cocaine inhibited neither Ca 2+ ATPase nor Ca 2+ release channel activity. These results demonstrate that cocaethylene has a more potent direct negative inotropic action on cardiomyocytes, without preventing Ca 2+ flux through the cardiac sarcoplasmic reticulum membrane.

The analysis of highly polymorphic regions of mitochondrial DNA is one of the most commonly used methods for personal identification. The recent advances of fluorescent detection in automated DNA sequencing (Smith et al. 1986) has made it possible a rapid analysis of sequence variants without using isotopic labeling.

In order to clarify the effect of methamphetamine (MA) on myocardium, histological, immunohistochemical and electron microscopic changes in the myocardium of rats were examined following daily intraperitoneal administration of MA at a dose of 1 mg per kg body weight for 4, 8, and 12 weeks before sacrifice. Normal saline (NS) was similarly injected for the same period before sacrifice to constitute a control group. Light microscopic changes found in the myocardium of the MA-treated group included atrophy, hypertrophy, patchy cellular infiltration, eosinophilic degeneration and disarray, edema myolysis, fibrosis, and the appearance of vacuoles. Ultrastructurally, nuclei and normal mitochondria had various shapes and there were dilated T tubules and sarcoplasmic reticulum, the accumulation of glycogen granules and fat droplets. Intra- and extra-cellular edema and intramyocytic vacuoles were often found. Withdrawal of MA at the twelfth week in another group of rats evidenced gradual recovery of the myocardial changes, commencing at 3 weeks after withdrawal. Optimism is therefore generated about the possibility of the affected hearts in MA-abuse patients returning towards the normal state if they give up the drug.

We evaluated the usefulness of a semi-nested polymerase chain reaction (PCR) method for detecting D1S80 (pMCT118) locus polymorphisms of DNA extracted from old skeletal remains. The semi-nested PCR has been applied to the amplification of D1S80 nucleic acid sequences. For amplification of the locus D1S80, a pair of oligonucleotide primers have been used widely as described by Kasai et al. We have designed another set of primers for semi-nested PCR. This method resulted in D1S80-VNTR detection from low-titered DNA isolated from old skeletal remains. The first and second step PCR achieved amplification from as little as 10 ng and 10 pg of template DNA, respectively. Specificity and sensitivity of the amplification products was markedly improved by semi-nested PCR. In DNA extracted from biological samples, this method took about 5 hours to amplify the target DNA and 3 hours for electrophoretic separation. We demonstrated that this semi-nested PCR method was superior in sensitivity to conventional 1-step standard amplification for VNTR typing of the D1S80 locus.

The D4S95-VNTR locus was amplified and the polymorphism analysed in a population sample of 169 randomly selected Japanese individuals. A total of 14 alleles containing 850–1360 base pairs were distinguished by agarose gel electrophoresis. The distribution of alleles was symmetrical with respect to one peak at 1030 bp. The mean exclusion chance and discrimination power were calculated as 0.604 and 0.876 respectively.