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Staphylococcus aureus is a commensal colonizer of both humans and animals, but also an opportunistic pathogen responsible for a multitude of diseases. In recent years, colonization of pigs by methicillin resistant S. aureus has become a problem with increasing numbers of humans being infected by livestock strains. In S. aureus colonization and virulence factor expression is controlled by the agr quorum sensing system, which responds to and is activated by self-generated, autoinducing peptides (AIPs). AIPs are also produced by coagulase negative staphylococci (CoNS) commonly found as commensals in both humans and animals, and interestingly, some of these inhibit S. aureus agr activity. Here, we have addressed if cross-communication occurs between S. aureus and CoNS strains isolated from pig nares, and if so, how properties such as host factor binding and biofilm formation are affected. From 25 pig nasal swabs we obtained 54 staphylococcal CoNS isolates belonging to 8 different species. Of these, none were able to induce S. aureus agr as monitored by reporter gene fusions to agr regulated genes but a number of agr-inhibiting species were identified including Staphylococcus hyicus, Staphylococcus simulans, Staphylococcus arlettae, Staphylococcus lentus, and Staphylococcus chromogenes. After establishing that the inhibitory activity was mediated via AgrC, the receptor of AIPs, we synthesized selective AIPs to explore their effect on adhesion of S. aureus to fibronectin, a host factor involved in S. aureus colonization. Here, we found that the CoNS AIPs did not affect adhesion of S. aureus except for strain 8325-4. When individual CoNS strains were co-cultured together with S. aureus we observed variable degrees of biofilm formation which did not correlate with agr interactions. Our results show that multiple CoNS species can be isolated from pig nares and that the majority of these produce AIPs that inhibit S. aureus agr. Further they show that the consequences of the interactions between CoNS and S. aureus are complex and highly strain dependent.

To examine rates of Shigella infections in household contacts of pediatric shigellosis patients, we followed contacts and controls prospectively for 1 week after the index patient obtained care. Household contacts of patients were 44 times more likely to develop a Shigella infection than were control contacts (odds ratio 44.7, 95% CI 5.5–361.6); 29 (94%) household contacts of shigellosis patients were infected with the same species and serotype as the index patient’s. Pulsed-field gel electrophoresis showed that 14 (88%) of 16 with infected contacts had strains that were indistinguishable from or closely related to the index patient’s strain. Latrine area fly counts were higher in patient households compared with control households, and 2 patient household water samples were positive for Shigella. We show high susceptibility of household contacts of shigellosis patients to Shigella infections and found environmental risk factors to be targeted in future interventions.

BACKGROUND:Atypical Shigella flexneri Z variant, that agglutinate with E1037 group factor specific monoclonal antisera against Shigella flexneri IV-I but not with other group or type specific antisera, has continuously being isolated in Bangladesh since 1997. Later this serotype has been reported in Indonesia, China and Argentina. Despite being a provisional serotype, continuous isolation of these strains in diverse geographical regions implicated a great necessity to study the overall characteristics of these strains. Therefore, we extensively characterized S. flexneri Z strains using various phenotypic and molecular tools. METHOD:Of 3569 S. flexneri isolated between 1997 and 2015, 95 strains were identified as S. flexneri Z using a panel of polyvalent absorbed antisera and monoclonal antisera of S. flexneri (MASF). Of them, randomly selected 65 strains were molecular O-serotyped using multiplex PCR and characterized using different phenotypic and molecular techniques (i.e.biotyping, plasmid profile, virulence marker and PFGE) to determine relationship with other subserotypes of S. flexneri. RESULTS:All these atypical S. flexneri Z strains were agglutinated with MASF B and IV-I antisera. Concordantly, these strains were positive to opt-gene, responsible for MASF IV-I sero-positive phenotype. However, molecular O-serotyping of all 65 strains could not differentiate between Z and Yb giving similar amplification products (wzx1-5 and opt). Contrarily, MASF based serotypic scheme distinguished among Z and Yb as well as Ya. All these S. flexneri Z showed typical biochemical reaction of S. flexneri, harboured a 140 MDa virulence plasmid and virulence markers namely ipaH, ial, sen, sigA and sepA genes. Along with the virulence plasmid, small plasmids (2.6, 1.8 and 1.6 MDa) were present as core plasmid. Moreover, a middle ranged plasmid and a 4.0 MDa sized plasmid were observed in 65% and 20% strains, respectively. Analysis of PFGE on XbaI-digested chromosomal DNA of Bangladeshi strains showed that S. flexneri Z had a close relatedness with Ya and Yb but completely different than the strains of Xa, Xb, 2a and 2b. This observation was found to be unequivocal while the overall result of biotyping, plasmid profile, and virulence factors was compared. Therefore, we conclude that these atypical serotype Z isolated in Bangladesh had a clonal relationship with Ya and Yb of Bangladesh and the opt gene played an important role in serotypic switching among them. Current serotyping scheme of S. flexneri strains fails to place many such atypical strains (1c, 1c+6, 1d, type 4, and 4c) including S. flexneri Z isolated from different parts of the world. Therefore, an updated serotyping scheme for identification of subserotypes of S. flexneri has been proposed to avoid multiple naming of the same subserotype having similar agglutination pattern.

Background and aims: Resistin is inflammatory adipocytokine released from adipose and other tissue. It is thought that it is related to insulin resistance and pathogenesis of gestational diabetes mellitus (GDM). This study was aimed to determine the level of serum resistin in mothers with GDM and normal glucose tolerance (NGT) in all trimesters to see whether it differs among different trimesters as well as between GDM and NGT. Materials and methods: This cross-sectional study included 81 pregnant women with GDM and 86 NGT after challenging three samples of 75 gm oral glucose tolerance test (OGTT) following WHO-2013 criteria. Resistin was measured from serum samples obtained in fasting state during OGTT. Resistin was measured by sandwich ELISA method. Results: Resistin level [13.2(9.85, 16.0) vs. 4.66(3.53, 5.96), median (IQR); p

Analyzing transportation and storage inefficiencies at the initial stages of the food supply chain is crucial for minimizing early-stage losses and enhancing food lifecycle efficiency. However, most food system studies,focused on retail and consumer stages. This study delves into the intricate dynamics of fresh fruit and vegetable waste generation at the supply-disposition storage stage, aiming to identify distinct waste generation patterns and predict food loss in Canada using regression analysis. Total food waste generation for 64 fresh fruits and vegetables exhibited a notable increase over a 22-year study period from 2000 to 2022, and fresh vegetables consistently surpassed fresh fruits in average waste generation by 25.9 %. Despite a higher per capita waste generation for fresh vegetables (1.26 kg∙cap-1∙year−1), the steeper growth rate in fruit waste emphasizes the need for nuanced strategies for each category at the supply-disposition storage. The waste generation showed a positive linear relationship with supply, imports, and domestic disappearance in the food supply chain (R2 = 0.80 to 0.99, p

Sustainability one of the burning issues in the global supply chain, and it is increasingly becoming a concern for textile industries. Moreover, developing countries have become the production hub of apparel and textiles, produced a high volume of waste and posed a threat to the environment and local community. By addressing sustainability challenges, Sustainable Supply Chain Management (SSCM) enhances long-term business viability and provides a competitive advantage. In this project, by extensive literature review, forty-five factors were identified which are driving the development process of SSCM. Responses were collected using the Likert Scale (1–5) from the focus group to narrow down the findings and ten have been selected as more appropriate in the perspective of Bangladesh. Later these ten factors were analyzed to find out the most influential factor using the Interpretive Structural Modeling (ISM) method by contextual relation-making. Community Groups and Environmental Organizations were found to be the most impactful among all the factors having the highest driving power.

3β-Hydroxysteroid dehydrogenases (3β-HSDs) catalyze the oxidative conversion of delta (5)-ene-3-beta-hydroxy steroids and ketosteroids. Human 3β-HSD type 2 (HSD3B2) is predominantly expressed in gonadal and adrenal steroidogenic cells for producing all classes of active steroid hormones. Mutations in HSD3B2 gene cause a rare form of congenital adrenal hyperplasia with varying degree of salt wasting and incomplete masculinization, resulting from reduced production of corticoids and androgens. Therefore, evaluation of the HSD3B2 enzymatic activity in both pathways for each steroid hormone production is important for accurately understanding and diagnosing this disorder. Using progesterone receptor (PR)- and androgen receptor (AR)-mediated transactivation, we adapted a method that easily evaluates enzymatic activity of HSD3B2 by quantifying the conversion from substrates [pregnenolone (P5) and dehydroepiandrosterone (DHEA)] to (progesterone and androstenedione). HEK293 cells were transduced to express human HSD3B2, and incubated medium containing P5 or DHEA. Depending on the incubation time with HSD3B2-expressing cells, the culture media progressively increased luciferase activities in CV-1 cells, transfected with the PR/AR expression vector and progesterone-/androgen-responsive reporter. Culture media from human and other mammalian HSD3B1-expressing cells also increased the luciferase activities. HEK293 cells expressing various missense mutations in the HSD3B2 gene revealed the potential of this system to evaluate the relationship between the enzymatic activities of mutant proteins and patient phenotype.

Handling of radioisotopes may cause external and internal contamination to occupational workers while using radiation for medical purposes. This research aims to monitor the internal hazard of occupational workers who handle 131I. Two methods are used: in vivo or direct method and in vitro or indirect method. The in vivo or direct method was performed by assessing thyroid intake with a thyroid uptake monitoring machine. The in vitro or indirect method was performed by assessing urine samples with the help of a gamma-ray spectroscopy practice using a High-Purity Germanium (HPGe) Detector. In this study, fifty-nine thyroid counts and fifty-nine urine samples were collected from seven occupational workers who were in charge of 131I at the National Institute of Nuclear Medicine and Allied Sciences (NINMAS), Dhaka. The result showed that the average annual effective dose of seven workforces from thyroid counts were 0.0208 mSv/y, 0.0180 mSv/y, 0.0135 mSv/y, 0.0169 m Sv/y, 0.0072 mSv/y, 0.0181 mSv/y, 0.0164 mSv/y and in urine samples 0.0832 mSv/y, 0.0770 mSv/y, 0.0732 mSv/y, 0.0693 mSv/y, 0.0715 mSv/y, 0.0662 mSv/y, 0.0708 mSv/y.The total annual effective dose (in vivo and in vitro method) was found among seven workers in average 0.1039 mSv/y, 0.0950 mSv/y, 0.0868 mSv/y, 0.0862 mSv/y, 0.0787 mSv/y, 0.0843 mSv/y, 0.0872 mSv/y. Following the rules of the International Commission on Radiological Protection (ICRP), the annual limit of effective dose for occupational exposure is 20 mSv per year and the finding values from this research work are lesser than this safety boundary.

This paper aims to explore the current stakeholder forces for sustainable supply chain management (SSCM) in the Bangladeshi garment industry. The focal point is identifying which stakeholder forces could enhance sustainable practices in the factory premises, and whether there are conflicting forces which might obstruct the sustainable practices. A qualitative research design is adopted, drawing on data from 37 semi-structured interviews with stakeholders related to garment manufacturing. Thematic analysis conceptually guides the analytical process. The findings demonstrate the supporting and hindering forces currently influencing the garment industry in Bangladesh. This paper also identifies three conflicting forces relating to economic gain, employee empowerment and global image, where trade-offs towards SSCM implementation exist. This study extends existing research relating to SSCM within the garment industry of Bangladesh, identifying differences between different stakeholder groups and recognising the conflicting forces that exist.

Current state of contamination and subsequent risk of contaminated sediment of a tidal river of Bangladesh was evaluated in the present study. Sediment samples were collected from five locations in the tributary of Bakkhali River estuary during summer (April) and winter (December) season, 2020. Collected samples were processed using standard protocol and the content of heavy metals (Cd, Cr, Cu, Pb and Zn) and metalloid (As), were analyzed by the Flame Atomic Absorption Spectrometer. Sediment contamination was evaluated by pollution load index (PLI), contamination factor (CF), degree of contamination (Cd), potential ecological risk index (PERI), non-carcinogenic and carcinogenic risk (CR) due to the dermal contact of the sediment. Multivariate statistical analysis such as principal component analysis (PCA) and cluster analysis (CA) were also applied to find out the possible sources of the contaminant in the sediment. Results showed the average concentration of As, Cd, Cr, Pb, Cu and Zn was 9.74 ± 3.57, 2.00 ± 0.85, 48.75 ± 8.92, 29.78 ± 8.39, 5.44 ± 2.03 and 56.94 ± 8.57 mg/kg, respectively. Concentration of Cu, Pb and Zn were within the recommended level whereas the concentration of As, Cd and Cr were suppressed the recommended level of WHO and FAO/WHO standards. PLI, CF and Cd revealed considerably low degree of contamination of the sediment. Geo-accumulation index indicated uncontaminated to moderately contaminated condition of the sediment. Although the values of enrichment factor revealed no potential enrichment for most of the metals, Cd showed a minor enrichment during the winter season. Based on the ecological risk assessment, the sediment from all of the sample locations was found to be of moderate to low risk. PCA and CA analysis revealed the origin of contaminants mainly from anthropogenic sources. Although different metals showed non-carcinogenic risk to the inhabitants, cancer risk values for dermal contact (CRderm) were much lower than 10−6 indicating no cancer risk for adult and child. However, the findings also revealed that children were more susceptible to CRderm compared to adults. The present study concluded that long term dermal contact of the sediment of Bakkhali River estuary will be contagious to the people. Therefore, regular monitoring of the estuarine environment is necessary so that contamination does not get worse.

Primary aldosteronism (PA) is the most common cause of endocrine hypertension and is often underdiagnosed. This condition is associated with increased cardiovascular morbidity and mortality in comparison to age and blood pressure matched individuals with essential hypertension (EH). The diagnostic pathway for PA consists of three phases: screening, confirmatory testing, and subtyping. The lack of specificity in the screening step, which relies on the aldosterone to renin ratio, necessitates confirmatory testing. The Endocrine Society’s clinical practice guideline suggests four confirmatory tests, including the fludrocortisone suppression test (FST), saline suppression test (SST), captopril challenge test (CCT), and oral sodium loading test (SLT). There is no universally accepted choice of confirmatory test, with practices varying among centers. The SST and FST are commonly used, but they can be resource-intensive, carry risks such as volume overload or hypokalemia, and are contraindicated in severe/ uncontrolled HTN as well as in cardiac and renal impairment. In contrast, CCT is a safe and inexpensive alternative that can be performed in an outpatient setting and can be applied when other tests are contraindicated. Despite its simplicity and convenience, the variability in captopril dose, testing posture, and diagnostic threshold limit its widespread use. This narrative review evaluates the diagnostic accuracy of the CCT across different populations, addresses controversies in its usage, and proposes recommendations for its use in the diagnosis of PA. Furthermore, suggestions for future research aimed at promoting the wider utilization of the CCT as a simpler, safer, and more cost-effective diagnostic test are discussed.

ABSTRACTFrench fries (FF) and fried chicken (FC) are known contributors to overweight and obesity among adolescents worldwide. Top selling five brands for both FF and FC were analyzed to determine their health compromising contents, which were sampled from the markets of Dhaka, Bangladesh. Sodium (Na) was determined by flame photometry, trans fatty acids (TFAs) by gas chromatography and heavy metals like arsenic (As), lead (Pb), cadmium and chromium by graphite furnace atomic absorption spectrophotometry. The median concentration of Na, TFA, As and Pb in FF was 0.45 gm/100 gm, 0.11 gm/100 gm, 0.93 mg/kg and 0.03 mg/kg, respectively. Similarly, in FC the median concentration of Na, TFA, As and Pb was 0.46 gm/100 gm, 0.13 gm/100 gm, 0.053 mg/kg and 0.06 mg/kg, respectively. The study findings suggests that consuming FF and FC impose a health risk among the exposed population.

Tea (Camellia sinensis) is a widely consumed beverage known for its numerous health benefits, largely attributed to its rich content of quality determining secondary metabolites such as methylxanthine compounds and bioactive phenolic compounds. The goal of this study was to find out variations of the levels of methylxanthines, bioactive phenolic compounds, and antioxidant activity in methanolic and hot water extracts of 129 tea samples grown in three different ecological regions of Bangladesh named Panchagar, Sylhet, and Chattogram. Methylxanthine and bioactive phenolic compounds were determined by using HPLC-DAD, and the antioxidant profile was analysed by UV–vis spectrophotometric methods for methanol and hot water extracts of tea leaves. The IC50 values showed the trend as Panchagar > Sylhet > Chattogram and Sylhet > Chattogram > Panchagar for water and methanol extract, respectively. The results revealed significant (p Chattogram > Sylhet. Caffeine was significantly higher (103.02 ± 5.55 mg/g of dry extract) in the methanolic extract of tea leaves of Panchagar district and lower (53.33 ± 4.30 mg/g of dry extract) in the hot water extract of Sylhet district. Panchagar and Chattogram possessed significantly (p

Here we investigated the effects of Ce and Mo doping on hydrothermally synthesized bismuth vanadate BiVO4 nanoparticles (NPs). The existence of monoclinic scheelite and tetragonal zircon phases of NPs was validated from Rietveld refinement of the powdered X-ray diffraction, room temperature Raman, and Fourier-transform infrared spectroscopy. The co-doping of Bi and V sites with respective Ce and Mo dopants in a mixed tetragonal zircon and monoclinic scheelite phases of BiVO4 lattice was corroborated from high-resolution transmission electron microscopy and X-ray photoelectron spectroscopy. The photoluminescence measurements revealed enhancement of photo-generated carrier recombination in (Ce, Mo) co-doped BiVO4 NPs which may have hampered its photocatalytic efficiency in degrading the methylene blue dye. The simulations based on Hubbard U corrected density functional theory (DFT+U) suggest that Mo and Ce co-doping introduced deep impurity states which may have facilitated the photo-generated carrier recombination detrimental to photocatalytic performance. The UV-vis diffuse reflectance measurements provided evidence for the presence of these defect states. In summary, this work may have presented a comprehensive experimental analysis of (Ce, Mo) doped BiVO4 supported by DFT simulations.

The prototypical toxic dye rhodamine B (RhB) is perhaps one of the most abundant pollutants in industrial wastewater. Its efficient photocatalytic degradation through composite photocatalysts is crucial for environmental remediation. Here, we synthesized quaternary Bi5O7I/Bi(IO3)3/Bi2(IO4)(IO3)3/BiOIO3 bismuth iodate composites through facile hydrothermal and solvothermal methods. The coexistence of multiple bismuth iodate phases was confirmed by x-ray diffraction analysis, room temperature Raman, and Fourier-transform infrared spectroscopy. The desired chemical states of Bi, I, and O inside the composites were confirmed by x-ray photoelectron spectroscopy. Field emission electron microscopy revealed flower-shaped nanosheet morphology for the composite synthesized at 120 °C, whereas randomly shaped nanoparticles with an average size of 80 nm were formed in the composite calcined at 400 °C. High-resolution transmission electron microscopy further corroborated the existence of multiple phases in the composites. The diffuse reflectance spectroscopy confirmed the optical absorption edges of the composites to be located within the visible range of 1.68–3.16 eV. The flower-shaped quaternary bismuth iodate composite demonstrated 100% degradation of RhB dye within 40 min of optical exposure. This quaternary bismuth iodate composite is suitable for solar harvesting-driven toxic dye remediation.

Ectopic parathyroid adenoma sometimes poses diagnostic challenge and can be a cause of persistent and recurrent primary hyperparathyroidism. Anterior mediastinum is one of the locations for ectopic parathyroid adenoma. Surgical excision is the only cure and for successful surgery, pre-operative localization is crucial. Chance of failed surgery is being increased without prior localization of the ectopic gland. The combination of single photon emission computed tomography (SPECT) and computed tomography (CT) has got high sensitivity for accurate localization of ectopic parathyroid. On the other hand, with accurate localization surgical outcome is excellent. Here we report, successful localization and management of a case of primary hyperparathyroidism due to adenoma in anterior mediastinum in 47-year-old man. IMC J Med Sci 2022; 16(2): 003. DOI: https://doi.org/10.55010/imcjms.16.013 *Correspondence: Dr. Nusrat Sultana, Room no-1620, Block-D, 15th floor, Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Email: nusrat_sultana@bsmmu.edu.bd

Background: Primary and secondary myelofibrosis has become a global burden due to its increased mortality and morbidity. Angiogenesis is a significant driving force in the development of fibrogenesis in the bone marrow, which leads to myelofibrosis. The microvascular density (MVD) with immunomarker CD34 can be used to assess the degree of angiogenesis. The objective of this study was to examine the association between degree of myelofibrosis and angiogenesis in hematological malignancies. Methods: Forty-six trephine biopsy specimens of various hematological malignancies with myelofibrosis were studied at the Department of Pathology of Bangabandhu Sheikh Mujib Medical University. Extent of myelofibrosis in each case was assessed by examining the reticulin and Masson’s trichrome stained sections using a semiquantitative grading system of bone marrow fibrosis (MF) within a scale of MF-0 to MF-3. Angiogenesis was measured by counting MVD in the ‘hotspots’ after immunostaining with CD34 antibody. Results: The trephine biopsy cases were grouped into early fibrotic (MF-1) and advanced fibrotic (MF-2,3) consisting of 16 (34.8%) and 30 (65.2%) patients, respectively. Angiogenesis was estimated as mean MVD count which revealed 16.7 ± 5.4 and 32.0 ± 11.5 in these groups, respectively. Significant difference of mean MVD values (P

A rigorous theoretical investigation has been made on the nonlinear propagation of dust-ion-acoustic shock waves in a multi-component magnetized pair-ion plasma (PIP) having inertial warm positive and negative ions, inertialess non-thermal electrons and positrons, and static negatively charged massive dust grains. The Burgers’ equation is derived by employing the reductive perturbation method. The plasma model supports both positive and negative shock structures in the presence of static negatively charged massive dust grains. It is found that the steepness of both positive and negative shock profiles declines with the increase of ion kinematic viscosity without affecting the height, and the increment of negative (positive) ion mass in the PIP system declines (enhances) the amplitude of the shock profile. It is also observed that the increase in oblique angle raises the height of the positive shock profile, and the height of the positive shock wave increases with the number density of positron. The applications of the findings from the present investigation are briefly discussed.

Abstract Background Association of single nucleotide polymorphisms (SNP) rs7756992 A/G and rs7754840 G/C of cyclin-dependent kinase 5 regulatory subunit-associated protein 1-like 1 (CDKAL1) gene with the susceptibility of gestational diabetes mellitus (GDM) has been studied in a group of Bangladeshi women. Methods In this case–control study, 212 GDM patients and 256 control subjects were genotyped for rs7756992 and rs7754840 by PCR-RFLP and TaqMan™ allelic discrimination assay method respectively. Genotyping results were confirmed by DNA sequencing and replicated TaqMan™ assay. The odds ratios and their 95% confidence interval were calculated by logistic regression to determine the associations between genotypes and GDM. Results The genotype frequencies of rs7756992-AA/AG/GG in the GDM group and the control group were 37%/48%, 53%/45%, 10%/7% and those of rs7754840-CC/CG/GG were 51%/55%, 40.1%/39.8%, 9%/5% respectively. Under dominant and log additive models rs7756992 was revealed significantly associated with GDM after being adjusted for family history of diabetes (FHD) and gravidity. Conversely, rs7754840 was significantly associated (P = 0.047) with GDM only under the recessive model after the same adjustment. The risk allele frequency of both SNPs was higher in the GDM group but significantly (P = 0.029) increased prevalence was observed in the rs7756992 G allele. When positive FHD and risk alleles of these SNPs were synergistically present in any pregnant woman, the chance of developing GDM was augmented by many folds. The codominant model revealed 2.5 and 2.1 folds increase in odds by AG (rs7756992) and GC (rs7754840) genotypes and 3.7 and 4.5 folds by GG (rs7756992) and CC (rs7754840) genotypes respectively. A significant 2.7 folds (P = 0.038) increase in odds of GDM resulted from the interaction of rs7756992 and family history of diabetes under the dominant model. The cumulative effect of multigravidity and risk alleles of these SNPs increased the odds of GDM more than 1.5 folds in different genotypes. Conclusion This study not only revealed a significant association between rs7756992 and rs7754840 with GDM but also provided the possibility as potential markers for foretelling about GDM and type 2 diabetes mellitus in Bangladeshi women.

Background: Diabetes mellitus (DM) is one of the growing health problems among the young population. Secretory defect of insulin is an important cause, and it can be assessed by measuring fasting serum C-peptide level. Aim: The aim of this article is to assess fasting serum C-peptide in young-onset DM individuals. Materials and Methods: This case–control study was conducted in the Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU) from March 2015 to February 2017. For this purpose, 40 individuals with DM (irrespective of DM type; age range: 11–29 years) were enrolled as case and an equal number of young healthy individuals as control. Demographic profiles, clinical profiles, and serum C-peptide were recorded in a standard and pre-tested structured datasheet. C-peptide was measured by the chemiluminescent immunometric assay. Results: Median fasting C-peptide was 2.67 [interquartile range (IQR) 1.06–4.07, range 0.12–20.0] ng/mL in diabetes individuals, whereas it was 2.19 (IQR 1.36–2.94, range 0.44–9.85) ng/mL in the control group; the difference was insignificant (P = 0.331). Waist circumference (WC) was significantly higher in the young diabetes group in comparison to that of control subjects and so were the plasma glucose values and diastolic blood pressure (P < 0.05 for all). Diabetic participants with low C-peptide group had significantly lower body mass index (BMI) and WC and higher fasting plasma glucose (FPG) and HbA1c in comparison to others (P < 0.05 for all); whereas the high C-peptide group had opposite body indices (higher BMI and WC) and glycemic parameters (lower FPG and HbA1c) (P < 0.05 for all). The classic hyperglycemic symptoms were more common in the low C-peptide group (P = 0.029). In participants with diabetes, C-peptide positively correlated with BMI and WC, whereas it showed a negative correlation with age (P < 0.05 for all). In the control group, C-peptide positively correlated with WC only (P = 0.018). Conclusion: The level of fasting serum C-peptide in diabetic subjects was similar to healthy controls, and it was higher in those subjects who had higher BMI, WC, and lower age.

In a menopausal lady, a reduced level of estrogen hormone leads to changes in the intraocular pressure (IOP) and retinal nerve fiber layer (RNFL) thickness in the eyes. This comparative study was carried out in the Outpatient Departments (OPD) of the Community Ophthalmology and Ophthalmology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from April 2017 to June 2019 to identify any difference in IOP and RNFL thickness in pre-menopausal and post-menopausal women aged 40-65 years. In this study, 60 pre-and post-menopausal women were included. Participants 40-50 years old with irregular menstruation were classified as group A, while those 51-65 years old with no menstruation for at least 12 months were classified as group B. More than one-fourth (26.7%) of participants had HTN in group A and 53.3% in group B. HTN was significantly associated with group B. The rise in menopausal age had a significant impact on the mean IOP and RNFL. The mean IOP in right eye (RE) was 11.80 (3.31) mm of Hg in Group A and 15.63 (3.01) mm of Hg in Group B. The mean IOP in left eye (LE) was 12.27(3.78) mm of Hg and 15.47(2.84) mm of Hg in Group A and Group B, respectively. The mean IOP of both eyes was 12.03±3.48 mmHg in Group A and 15.55±2.82 mmHg in Group B. The mean difference of IOP in RE, LE and both were statistically significant between the two groups. The mean RNFL in RE was 103.97±7.42 μm in Group A and 98.90±}6.21 μm in Group B. The mean RNFL in LE was 101.87±6.69 μm and 97.97±6.65 μm in Group A and Group B, respectively. The mean RNFL of both eyes was 102.92±7.77 μm in Group A and 98.45±7.86 μm in Group B. The mean RNFL was statistically significant between the two groups. Post-menopausal women are at an increased risk of developing elevated IOP and thin RNFL than premenopausal women. BSMMU J 2022; 15(2): 61-64

The modulational instability (MI) of ion-acoustic waves (IAWs) is examined theoretically in a four-component plasma system containing inertialess electrons featuring a non-thermal, non-extensive distribution, iso-thermal positrons, and positively as well as negatively charged inertial ions. In this connection, a non-linear Schrödinger equation (NLSE), which dominates the conditions for MI associated with IAWs, is obtained by using the reductive perturbation method. The numerical analysis of the NLSE reveals that the increment in non-thermality leads to a more unstable state, whereas the enhancement in non-extensivity introduces a less unstable state. It also signifies the bright (dark) ion-acoustic (IA) envelope solitons mode in the unstable (stable) domain. The conditions for MI and its growth rate in the unstable regime of the IAWs are vigorously modified by the different plasma parameters (viz., non-thermal, non-extensive q-distributed electron, iso-thermal positron, the ion charge state, the mass of the ion and positron, non-thermal parameter α, the temperature of electron and positron, etc.). Our findings may supplement and add to prior research in non-thermal, non-extensive electrons and iso-thermal positrons that can co-exist with positive as well as negative inertial ions.

Cabbage, cauliflower and broccoli are well-known vegetables from the Brassica family having functional effects on human health. This study was carried out to identify different antioxidant properties and to quantify phenolic compounds by HPLC-DAD in different extracts (methanol, ethanol and water: acetic acid: acetone) of these vegetables. The results showed that, the methanolic dry extract of cabbage possessed the highest antioxidant activity (549 ± 7.30 μg/g) and IC50 was 90 ± 2.52 μg/mL than others. Whereas the ethanolic dry extract of cauliflower had 348 ± 5.20 μg/g of flavonoid, which was the highest among all. The maximum levels of total tannin (414 ± 5.20 μg/g) and total phenolic content (465 ± 3.25 μg/g) was found in broccoli dry extract. Several polyphenolic compounds were identified in different extracts of the vegetables and they were Cauliflower (8) > Cabbage (10) > Broccoli (9) in total. Therefore, the use of total vegetables rather than extracts in the food industry would be more appropriate to get greater health benefit.

A theoretical investigation has been carried out to examine the ion-acoustic shock waves (IASHWs) in a magnetized degenerate quantum plasma system containing inertialess ultra-relativistically degenerate electrons, and inertial non-relativistic positively charged heavy and light ions. The Burgers equation is derived by employing the reductive perturbation method. It can be seen that under the consideration of non-relativistic positively charged heavy and light ions, the plasma model only supports the positive electrostatic shock structure. It is also observed that the charge state and number density of the non-relativistic heavy and light ions enhance the amplitude of IASHWs, and the steepness of the shock profile is decreased with ion kinematic viscosity. The findings of our present investigation will be helpful in understanding the nonlinear propagation of IASHWs in white dwarfs and neutron stars.

Abstract Collectively, rare genetic diseases affect a significant number of individuals worldwide. In this study, we have conducted whole-exome sequencing (WES) and identified underlying pathogenic or likely pathogenic variants in five children with rare genetic diseases. We present evidence for disease-causing autosomal recessive variants in a range of disease-associated genes such as DHH-associated 46,XY gonadal dysgenesis (GD) or 46,XY sex reversal 7, GNPTAB-associated mucolipidosis II alpha/beta (ML II), BBS1-associated Bardet–Biedl Syndrome (BBS), SURF1-associated Leigh Syndrome (LS) and AP4B1-associated spastic paraplegia-47 (SPG47) in unrelated affected members from Bangladesh. Our analysis pipeline detected three homozygous mutations, including a novel c. 863 G > C (p.Pro288Arg) variant in DHH, and two compound heterozygous variants, including two novel variants: c.2972dupT (p.Met991Ilefs*) in GNPTAB and c.229 G > C (p.Gly77Arg) in SURF1. All mutations were validated by Sanger sequencing. Collectively, this study adds to the genetic heterogeneity of rare genetic diseases and is the first report elucidating the genetic profile of (consanguineous and nonconsanguineous) rare genetic diseases in the Bangladesh population.

Background: Gestational diabetes mellitus (GDM) shows insufficient β-cell compensation for insulin resistance (IR) during late pregnancy, whereupon derangements of human placental lactogen (hPL) and prolactin (PRL) have a presumed role in its pathogenesis. Aims: To assess the relationship of serum hPL and PRL with IR and β-cell function in GDM and pregnant women with normal glucose tolerance (NGT). Materials and Methods: This cross-sectional study was performed with 40 women with GDM and an equal number of pregnant women with NGT who were diagnosed on the basis of the WHO 2013 criteria during 24–40 weeks of gestation. hPL was measured by an enzyme-linked immunosorbent assay (ELISA); PRL and fasting insulin were measured by a chemiluminescent immunoassay. Equations of homeostatic model assessment (HOMA) were used to calculate the indices of IR (HOMA-IR) and β-cell function (HOMA-B). Results: No statistically significant difference was found between the GDM and NGT groups in circulating concentrations of either hPL (6.01 ± 1.76 vs. 5.92 ± 2.10 mg/L, mean ± SD; P = 0.852) or PR [180.27 (125.95–306.20) vs. 166.87 (134.24–284.70) ng/mL, median (IQR); P = 0.704]. There was no relationship of circulatory levels of hPL and PRL with glucose values at different time points during oral glucose tolerance test as well as with AUCglucose (P = NS for all). On multiple regression analysis, neither hPL nor PRL emerged as a significant predictor for fasting insulin, HOMA-IR, and HOMA-B in GDM (P = NS for all). Conclusions: Circulating concentration of hPL and PRL may not be a potential determinant of IR and β-cell dysfunction in GDM.

Objective: To document the clinical, biochemical and imaging phenotypes of immunocompetent patients with adrenal histoplasmosis. Methods: The clinical, biochemical and radiologic data of 18 immunocompetent patients [age: 45.00 (39.25, 56.25) years, median (IQR), m/f (16/2)] with adrenal histoplasmosis presenting in the Department of Endocrinology, BSMMU between 2014 and 2020 were retrospectively analyzed. Results: All patients were seronegative for HIV infection, and 27.8% (5/18) had well controlled diabetes mellitus. The median duration of the symptoms was 6.00 (IQR: 4.00, 11.25) months. All had significant weight loss, anorexia and weakness. Fever was present in 61.1% (11/18) patients and night sweat was present in 27.8% (5/18) cases. Hypotension and hyperpigmentation were present in 55.6% (10/18) and 66.7% (12/18) cases, respectively. Three of 18 patients presented with adrenal crisis. Hyponatremia occurred in 55.6% (10/18) cases, but none had hyperkalemia. Thirteen of 18 patients had adrenal insufficiency whereas 83.3% (15/18) had high adrenocorticotropic hormone. CT scan revealed bilateral adrenal enlargement in all cases with oval shape and regular margin. All were hypodense having radiodensity 21-90 hounsfield unit, and 11.1% (2/18) were heterogeneous in contrast enhancement. None had noticeable calcification whereas 1.1% (2/18) cases had central necrosis with peripheral rim enhancement. Hepatomegaly was present in 6 cases, splenomegaly in 3 cases and 5 patients had abdominal lymphadenopathy. Histoplasmosis were confirmed by positive fine needle aspiration cytology of adrenal tissue. Conclusions: Adrenal histoplasmosis should be considered in the list of differentials of bilateral adrenomegaly in immunocompetent individuals even living in non-endemic areas.

Abstract Background Gibberellin (GA) is one of the most essential phytohormones that modulate plant growth and development. Jute (Corchorus sp.) is the second most important source of bast fiber. Our result has shown that exogenous GA can positively regulate jute height and related characteristics which mean increasing endogenous GA production will help to get a jute variety with improved characteristics. However, genes involved in jute GA biosynthesis have not been analyzed precisely. Results Genome-wide analysis identified twenty-two candidate genes involved in jute GA biosynthesis pathway. Among them, four genes- CoCPS, CoKS, CoKO and CoKAO work in early steps. Seven CoGA20oxs, three CoGA3oxs, and eight GA2oxs genes work in the later steps. These genes were characterized through phylogenetic, motif, gene structure, and promoter region analysis along with chromosomal localization. Spatial gene expression analysis revealed that 11 GA oxidases were actively related to jute GA production and four of them were marked as key regulators based on their expression level. All the biosynthesis genes both early and later steps showed tissue specificity. GA oxidase genes were under feedback regulation whereas early steps genes were not subject to such regulation. Conclusion Enriched knowledge about jute GA biosynthesis pathway and genes will help to increase endogenous GA production in jute by changing the expression level of key regulator genes. CoGA20ox7, CoGA3ox2, CoGA2ox3, and CoGA2ox5 may be the most important genes for GA production.

T-box transcription factor 5 gene (TBX5) encodes the transcription factor TBX5, which plays a crucial role in the development of heart and upper limbs. Damaging single nucleotide variants in this gene alter the protein structure, disturb the functions of TBX5, and ultimately cause Holt-Oram Syndrome (HOS). By analyzing the available single nucleotide polymorphism information in the dbSNP database, this study was designed to identify the most deleterious TBX5 SNPs through in silico approaches and predict their structural and functional consequences.Fifty-eight missense substitutions were found damaging by sequence homology-based tools: SIFT and PROVEAN, and structure homology-based tool PolyPhen-2. Various disease association meta-predictors further scrutinized these SNPs. Additionally, conservation profile of the amino acid residues, their surface accessibility, stability, and structural integrity of the native protein upon mutations were assessed. From these analyses, finally 5 SNPs were detected as the most damaging ones: [rs1565941579 (P85S), rs1269970792 (W121R), rs772248871 (V153D), rs769113870 (E208D), and rs1318021626 (I222N)]. Analyses of stop-lost, nonsense, UTR, and splice site SNPs were also conducted.Through integrative bioinformatics analyses, this study has identified the SNPs that are deleterious to the TBX5 protein structure and have the potential to cause HOS. Further wet-lab experiments can validate these findings.

Silent corticotroph adenoma (SCA) is an unusual type of nonfunctioning pituitary adenoma (NFA) that is silent both clinically and biochemically and can only be recognized by positive immunostaining for ACTH. Under rare circumstances, it can transform into hormonally active disease presenting with severe Cushing syndrome. It might often produce diagnostic dilemma with difficult management issue if not thoroughly investigated and subtyped accordingly following surgery. Here, we present a 21-year-old male who initially underwent pituitary adenomectomy for presumed NFA with compressive symptoms. However, he developed recurrent and invasive macroadenoma with severe clinical as well as biochemical hypercortisolism during post-surgical follow-up. Repeat pituitary surgery was carried out urgently as there was significant optic chiasmal compression. Immunohistochemical analysis of the tumor tissue obtained on repeat surgery proved it to be an aggressive corticotroph adenoma. Though not cured, he showed marked clinical and biochemical improvement in the immediate postoperative period. Anticipating recurrence from the residual tumor, we referred him for cyber knife radio surgery.

To examine rates of Shigella infections in household contacts of pediatric shigellosis patients, we followed contacts and controls prospectively for 1 week after the index patient obtained care. Household contacts of patients were 44 times more likely to develop a Shigella infection than were control contacts (odds ratio 44.7, 95% CI 5.5-361.6); 29 (94%) household contacts of shigellosis patients were infected with the same species and serotype as the index patient's. Pulsed-field gel electrophoresis showed that 14 (88%) of 16 with infected contacts had strains that were indistinguishable from or closely related to the index patient's strain. Latrine area fly counts were higher in patient households compared with control households, and 2 patient household water samples were positive for Shigella. We show high susceptibility of household contacts of shigellosis patients to Shigella infections and found environmental risk factors to be targeted in future interventions. [ABSTRACT FROM AUTHOR]

Poor weaning practice and malnutrition among under 5 (yrs) children are still major public health issues in Bangladesh. This study aimed to develop a cheap and nutritious weaning food for the children of Bangladesh. For this purpose, three weaning formulations of Q1, Q2, and Q3 with different ratios of germinated wheat, germinated mung-bean, and soya-bean, and a constant amount of sweet potato, sugar, salt, and milk flavor were processed and evaluated. The prepared formulations were investigated for proximate composition and sensory evaluation and compared with six commercial weaning food products. The proximate composition values indicated that the fat content of formulated foods ranged between 09.29% and 11.40%. The carbohydrate content was ranged between 52.80% and 61.20%, which was low compared with commercial ones. The protein content of the formulated foods was 20.33%–27.70%, and that was approximately two times more than available commercial foods. The energy content was also more than locally available commercial weaning foods, which were 411.40 ± 1.51 kcal to 419.30 ± 1.12 kcal. Sample Q2 had an 8.4 acceptance score in sensory analysis of a 9-point hedonic scale scorecard, which made it more acceptable than the other two samples. The values of mineral elements (Na, K, Fe) were similar to all analyzed varieties of commercial weaning foods. This nutrient-enriched weaning food will easily be affordable for the people of developing countries like Bangladesh. The results showed that the formulated weaning food had the desired characteristics of a weaning food; hence, it could decrease malnutrition in children.

Background. Reproduction is important in animal production, and follicle evaluation is a remarkable reproductive aspect by which ovaries can be accurately evaluated since ovarian follicles are the organ's functional units and each contain an oocyte and related somatic cells. Objective. The objective of this study was to evaluate the abattoir cattle ovaries and follicles for potential in vitro production of embryos. Methodology. Ovaries were collected and categorized based on the presence of corpus luteum (CL; with or without). Thereafter, ovaries were processed and follicles were counted through naked eye estimation as well histologically. Data were analyzed using the GLM procedure in SAS. Also, relationships between follicles in both types of ovaries were calculated using Pearson correlations. Results. From a total of sixteen cattle ovaries, 62.5% had absence of CL whereas 37.5% ovaries had CL. Regarding morphometric measurements, ovaries with CL were 48% higher (P < 0.05) in weight than those ovaries without CL. Correlations between length and weight in ovaries without CL were high (r= 0.87) and, diameter and weight in ovaries with CL were low (r= 0.41). Results exposed that the amount of follicles with 2-6 mm diameter were significantly (P < 0.05) higher (61% more) in ovaries without CL compared to those with CL. Primary and secondary follicles presence were higher (P < 0.05) in ovaries without CL (120% more) than in those with CL (89%). Greater (P < 0.05) numbers of normal and lower (P < 0.05) amount of degenerated follicles were found in ovaries without CL. Implications. Overall, our data suggest that ovaries without CL are a potential source for quality follicles and this study provides new insights that may serve as the baseline information to produce high-quality oocyte with potential use for in vitro production of tropical cattle. Conclusions. This study corroborated that CL influences growth and development of the follicles and cell degeneration. As a result, the developmental competence of oocytes and embryo production will be negatively affected by the ovaries with CL. Ovaries without CL will provide quality follicles and cumulus-oocyte complexes.

ABSTRACT: Objective: Disorders of sex development (DSD) are defined as conditions in which chromosomal sex is inconsistent with phenotypic sex, or in which the phenotype is not classifiable as either male or female. Mutations in genes present in X, Y or autosomal chromosomes can cause abnormalities of testis determination or 46,XY DSD. Leydig cell hypoplasia (LCH), also known as Leydig cell agenesis, is a rare autosomal recessive endocrine syndrome of 46,XY DSD. Our objective here is to present the case of a 27-year-old, phenotypic female who presented with primary amenorrhea and later found to have LCH. Methods: We used formatted history and clinical examination followed by necessary hormonal investigations. The diagnosis was confirmed by histopathology of resected testes and genetic mutation analysis. Results: The patient's physical examination was unremarkable except 2 ovoid lumps present in the inguinovulvar region. There were no müllerian structures on sonography. Estrogen and both basal and stimulated testosterone levels were low whereas luteinizing hormone and follicle-stimulating hormone were high. Her chromosomal sex was found to be 46,XY. The histopathology of the resected inguinal lumps showed atrophic testicular change lacking Leydig cells with relative preservation of Sertoli cells. Genetic mutation analysis failed to reveal any significant aberration in the LHCGR gene. At present she is on estrogen replacement therapy having undergone bilateral orchidectomy and vaginoplasty. Conclusion: LCH represents a unique example of diagnostic dilemma in gender identification. It requires a multidisciplinary approach for optimum outcome.

Congenital adrenal hyperplasia (CAH) due to the three-beta-hydroxysteroid-dehydrogenase (3β-HSD) enzyme deficiency is a rare autosomal recessive disorder presenting with sexual precocity in a phenotypic male. Klinefelter syndrome (KS) is the most common sex chromosome aneuploidy presenting with hypergonadotropic hypogonadism in a male. However, only a handful of cases of mosaic KS have been described in the literature. The co-existence of mosaic KS with CAH due to 3β-HSD enzyme deficiency portrays a unique diagnostic paradox where features of gonadal androgen deficiency are masked by simultaneous adrenal androgen excess. Here, we report a 7-year-old phenotypic male boy who, at birth presented with ambiguous genitalia, probably a microphallus with penoscrotal hypospadias. Later on, he developed accelerated growth with advanced bone age, premature pubarche, phallic enlargement and hyperpigmentation. Biochemically, the patient was proven to have CAH due to 3β-HSD deficiency. However, the co-existence of bilateral cryptorchidism made us to consider the possibility of hypogonadism as well, and it was further explained by concurrent existence of mosaic KS (47,XXY/46,XX). He was started on glucocorticoid and mineralocorticoid replacement and underwent right-sided orchidopexy on a later date. He showed significant clinical and biochemical improvement on subsequent follow-up. However, the declining value of serum testosterone was accompanied by rising level of FSH thereby unmasking hypergonadotropic hypogonadism due to mosaic KS. In future, we are planning to place him on androgen replacement as well.

The article offers information on the development and implementation of duty-free quota-free (DFQF) market access regime for least developed country (LDC) under the Generalized System of Preference (GSP) mechanism. It analyzes the role of the General Agreement on Tariffs and Trade (GATT) regime in settlement of trade negotiations of the World Trade Organization (WTO).

Medicinal plants are the major sources of traditional treatment of disease in Indian subcontinent due to abundant presence of plants and vast side effects of synthetic drug. The present study was subjected to observe in vitro thrombolytic, antibacterial, and in vivo antidiarrheal activities of methanol soluble fraction of fruits of Annona muricata. In thrombolytic activity assay, various concentrations (2 ─ 10 mg/ml) of methanol soluble fraction was used and dose dependently less potent activity was found. The maximum clot lysis 18.33% (p* < 0.05) was achieved at 10 mg/ml of methanolic fruit extract, whereas standard drug streptokinase showed 55.50% (p*** < 0.001) clot lysis. In antibacterial assay, disc diffusion method was used comprising two gram positive (S. aureus and Micrococcus luteus) and two gram negative (E. coli and P. aeruginosa) bacteria. None of four (0.25, 0.5, 1, and 5 mg/disc) concentration of fruit extract showed antibacterial potentiality, whereas standard amikacin (3 mg/disc) revealed strong antibacterial activities (=~ 23 ─ 24 mm of MIC). To evaluate antidiarrheal activity, castor oil induced diarrhea was created in Swiss albino mice and different doses (100, 200, and 400 mg/kgbw) of fruit extract was introduced post orally. All of three different doses of fruit extract showed significant (p < 0.05 ─ 0.001) antidiarrheal activities. Notably, the percent inhibition of diarrhea by methanolic extract of fruits of Annona muricata was found to be 58.38% at a dose of 400 mg/kgbw. The effect of vehicle saline (10 ml/kgbw) was considered as control and loperamide (5 mg/kgbw) as standard that provided 67.01% inhibition of diarrhea. The results suggest that, the fruits of Annona muricata possess potent antidiarrheal properties, providing scientific basis of using the plant parts in the treatment of diarrheal disease.

The modulational instability (MI) of ion-acoustic (IA) waves (IAWs) and associated IA rogue waves (IARWs) are studied in double-pair plasma containing inertial positive and negative ions, inertialess non-extensive electrons and iso-thermal positrons. A standard nonlinear Schrödinger equation (NLSE) is derived by employing reductive perturbation method. It can be seen from the numerical analysis that the plasma system supports both modulationally stable (unstable) parametric regime in which the dispersive and nonlinear coefficients of the NLSE have opposite (same) sign. It is also found that the basic features of IAWs (viz., MI criteria of IAWs, amplitude, and width of the IARWs, etc.) are rigorously changed by the plasma parameters such as mass, charge state, and number density of the plasma species. The outcomes of our present investigation should be useful in understanding the propagation of nonlinear electrostatic IAWs and associated IARWs in astrophysical and laboratory plasmas.

ABSTRACT: Objective: Medullary thyroid carcinomas (MTCs) originate from parafollicular C cells and produce the hormone calcitonin, which is primarily responsible for the biochemical dysfunction in calcium metabolism seen in MTC. MTCs constitute only about 5 to 7% of thyroid neoplasms. In rare cases, serum calcitonin can be normal or undetectable.Methods: We present the clinical examination and laboratory findings of a patient with MTC and a review of the literature.Results: A female of 65 years was suspected to have MTC after fine-needle aspiration cytology but serum calcitonin was normal. A total thyroidectomy was performed. Histopathology confirmed MTC. During the 9-year follow-up period, she had persistently normal serum calcitonin level despite lymph node metastasis.Conclusion: Raised serum calcitonin is a biochemical hallmark of diagnosis and recurrence of MTC in the post-surgical period. Our patient, however, is a case of MTC with postsurgical recurrence and metastasis but persistently normal calcitonin. Such cases are challenging in management. We have not found another report in the literature with the combination of normal calcitonin, MTC, and postsurgical recurrence with metastasis in lymph nodes.Abbreviations: CEA = carcinoembryonic antigen; CT = calcitonin; CT-NEG-MTC = calcitonin-negative medullary thyroid cancer; FNAC = fine-needle aspiration cytology; MTC = medullary thyroid carcinoma

Empty Sella refers to the absence or relative absence of the pituitary gland on radiologic imaging of the Sella turcica. This is usually an incidental finding, and as few as 10% patients presents with Hypopituitarism. The authors report a 13.5-year-old boy who presei1ted with short stature and absence of signs of pubertal onset. Hormonal assay showed panhypopi­tuitarism. X-ray left wrist joint showed delayed bone age and finally MRl of the brain revealed empty Sella. Growth hormone replacement therapy was started to increase the height. The boy is now on regular follow up to monitor response to treatment.

Background: Nodular goiter is common in Bangladesh. Thyroid nodules are important for their malignant potential especially the solitary and cold ones and when functionally euthyroid. Objectives: This study was designed to investigate the frequency of malignancy and cellular aberration detected by fine needle aspiration cytology (FNAC) in euthyroid nodules and its correlation with clinical findings. Methods: Subjects with nodular goiter attending Endocrine out patient department [n=150, nonpregnant, age (mean± SD): 37±12 years; sex (male: female): 21:129] were recruited for this study. All subjects underwent clinical risk stratification, estimation ofFT4 and TSH as well as ultrnsonogram (USG) and isotope scan of thyroid. Thyroid nodules were categorized into malignant, suspicious, benign and indeterminant on the basis of cellular character by FNAC. Statistical analysis was done by Chi-square and multiple regression analysis. Results: Patients were mostly females (86%) and 4.7% had family history of thyroid problems. Some had recent changes of size (14.7%), pain in the nodule (4%) and dysphagia (6%). Nodules were solitary in 45.3% and the rest (54.7%) had multinodular goiter. Enlarged regional lymph node was found in 12.7% patients. About 41 % were partially-cold followed by cold nodules (26.7%), patchy (16.7%), isoform (12%) and hot (4%) by isotope scan. Frequency of malignant (10%) character was highest in cold nodules followed by uniform (5.6%), patchy (4.0%) and partially cold (1.6%) while none in hot nodules; which were 22.5%, 11.1 %, 4.0%, 9.8% and 16.7% respectively for suspicious nodules. About 17% showed cellular aberration and 4.7% were clearly malignant, whereas 124 (82.7%) were benign. Of the malignant, 4 were solitary and 3 were multinodular; which were 10 and 9 among the suspicious ones. A significant number (77%, 20 out of 26) among the malignant/suspicious nodules fell into moderate to high risk category (x2=22.861, p4 cm (p=0.039) and recent changes in nodular size (p=0.042) were independently and signifi­cantly related to cellular aberration. Conclusions: FNAC is a useful tool for cellular diagnosis of thyroid nodules. Clinical suspicion for malignancy strongly correlates with the FNAC findings. But a good number of clinically Low risk categories would escape malignant cellular character unless FNAC is done.

The exact cause of essential hypertension remains unclear. There is evidence to suggest that the development of essential hypertension is causally related to serum calcium levels. This study was designed to assess the status of serum calcium level in patients with essential hypertension and compared with healthy control. The research study was cross-sectional observational in nature. This study was done at the Department of Physiology in Sylhet MAG Osmani Medical College, Sylhet, Bangladesh. The duration of the research period was one year. All the known case of hypertension and newly diagnosed hypertensive patients were selected and compared with age-sex matched apparently healthy individual. Age below 18 years, pregnant women and patients taking supplementary calcium therapy were excluded from this study. Blood pressure was measured by auscultatory method; aneroid sphygmomanometer and standard stethoscope were used. Automated chemistry analyzer Vitrose-350, USA was used to estimate serum calcium level. Standard operating procedure strictly followed. There were 62 hypertensive (both known case of hypertension and newly diagnosed cases) were selected in hypertensive group (Group A) and 62 age-sex matched apparently healthy individuals were selected in normotensive group (Group B). The mean age of hypertensive and normotensive subjects was not statistically significant (p=0.814). There were 27(43.5%) male and 35(56.5%) female in hypertensive group, 32(51.8%) male and 30(48.4%) female in normotensive group. The distribution was statistically not significant (p=0.472). The mean value of the systolic blood pressure (SBP) was 146.45±5.82 mm Hg and the mean value of the diastolic blood pressure (DBP) was 92.90±7.66 mm Hg in hypertensive group. The mean value of the SBP was 112.74±6.88 mm Hg and the mean value of the DBP was 74.52±5.33 mm Hg of the normotensive group. The difference in mean blood pressure (BP) between the two groups was highly significant (p<0.001). The mean value of the serum calcium level was 8.59±0.55 mg/dl in hypertensive group and 9.12±0.93 mg/dl in normotensive group, which was statistically significant (p <0.001) between two groups. Serum calcium was significantly lower in hypertensive group than normotensive group. There was a negative correlation of the serum calcium level with both systolic and diastolic blood pressure.