• Maurer Gibbons posted an update 3 months, 1 week ago

    Leptin is an adipocytokine secreted by adipocytes which positively correlates with obesity. It is considered as a potential mediator for precipitating Gestational diabetes mellitus (GDM) which is more evident during 24-28 weeks of gestation. This study was conducted to see serum leptin level during 24-28 weeks of gestation in GDM at the Department of Endocrinology, BSMMU, Bangladesh from March 2019 to August 2020. Pregnant women (N=108) were challenged with 75gm oral glucose (OGTT) at 24-28 weeks of gestation and divided into GDM [n=45, age 27.80±3.98 years, mean±SD; BMI 27.88 (24.46-30.43) kg/m², median Interquartile range (IQR)] and normal glucose tolerance [NGT; n=62, age 26.19±5.30 years, mean±SD; BMI 25.80 (23.65-28.42) kg/m², median (IQR)] on basis of WHO-2013 diagnostic criteria. Fasting serum leptin and glucose were measured by ELISA and glucose oxidase method respectively. No statistically significant difference was found between GDM and NGT for leptin [26.05(16.92-50.55) vs. 23.50(14.95-38.30) mediaction over GDM.Chronic abnormal uterine bleeding (AUB) is common, but there is a lack of standardized methods for investigating and etiological categorization of AUB. The PALM-COEIN classification system of AUB is getting important to overcome this issue. This cross-sectional study was conducted from January 2019 to December 2019 at Mymensingh Medical College Hospital, Mymensingh, Bangladesh, to determine the causes of AUB in women of the reproductive age group and categorize the causes of AUB as per the PALM-COEIN classification. A total of 380 women with chronic AUB were evaluated. The distribution of PALM-COEIN causes of AUB were AUB-P (1.8%), AUB-A (9.2%), AUB-L (13.2%), AUB-M (5.8%), AUB-C (1.1%), AUB-O (24.7%), AUB-E (1.6%), AUB-I (6.6%), and AUB-N (36.1%). The participants’ mean age was 29.6 (±10.5) years, the majority (78.2%) of them was married, only a few (9.5%) had comorbid diseases, including hypertension (HTN) (1.1%), diabetes mellitus (DM) (5.3%), and hypothyroidism (8.7%). Women in the AUB-M classification had higher age than others; anemia was more prevalent in the AUB-P group, the AUB-O group had the highest TSH levels and hypothyroidism frequency. The PALM-COEIN classification helps ascertain the cause of AUB practically and should be used in routine clinical practices to manage these patients better.Treatment of sub-trochanteric femoral fractures is a challenge to orthopaedic surgeons. High incidence of fixation failure and nonunion is due to thick cortical bone deserves special consideration of surgical treatment. Intramedullary nail by Surgical Implant Generation Network (SIGN) shows promising results in comparison to conventional fixation method because of its better strength, accuracy and surprisingly better results in infection and non-union. The aim of this study was to assess the rate and time taken for union of fractures by SIGN nail and determine peri-operative parameters. This prospective study was conducted from July 2016 to June 2018 at National Institute of Traumatology and Orthopaedic rehabilitation (NITOR) through non randomized purposive sampling. Total 31 patients, aged above 18 years irrespective of sex with closed subtrochanteric fractures were included. Patients with pathological fracture, multiple injuries were excluded from the study. Union status evaluated by Radiographic Union Scohe treatment of subtrochanteric femoral fractures.Acute bronchiolitis is a viral respiratory illness of infants and young children that occurs in the first two years of life. It is a major cause of hospital admissions in Bangladesh. Management of bronchiolitis is a great challenge for the pediatrician both in the outpatient and inpatient department. Because mainstay of treatment options are usually supportive like cool humidified oxygen, fluids, bronchodilators, epinephrine and corticosteroids. A number of agents have been proposed as adjunctive therapies, but their effects are controversial. Nebulized hypertonic saline (3%) has been reported to have some benefit in recent studies. So the objective of this study was to compare the efficacy of nebulized 3% hypertonic saline (HS) with salbutamol and normal saline (0.9%) nebulization in children with acute bronchiolitis. A double-blind randomized controlled trial was conducted in the Department of Paediatrics, Mymensingh Medical College Hospital, Bangladesh from November 2015 to October 2016. A total of 100 chi05). So in acute bronchiolitis nebulized hypertonic saline (3%) is as effective as normal saline (0.9%) and salbutamol nebulization.Proteus is considered as one of the major opportunistic pathogens liable for nosocomial infections and acquired several resistances to a wide range of antimicrobials such as aminoglycosides. The most common mechanism of aminoglycoside resistance is the inactivation of drugs by modifying enzymes. So, this cross-sectional study was undertaken to investigate the occurrence of aminoglycoside resistance and identify aminoglycoside modifying enzyme (AME) genes among clinical isolates of aminoglycoside resistant Proteus spp. A total of 40 Proteusmirabilis and Proteus vulgaris were isolated in the Department of Microbiology of Dhaka Medical College, Dhaka, Bangladesh from July 2018 to June 2019 of 500 wound swab & pus, urine and blood samples. Disk diffusion test was performed by modified Kirby Bauer method. Minimum inhibitory concentration (MIC) of amikacin was determined by agar dilution method. PCR was used to detect aac(3)-Ia, aac(6′)-Ib, ant(4′)-IIa, ant(2”)-Ia a and aph(3”)-Ib AMEs genes among aminoglycoside resistant Proteus spp. Sequencing of aac(6′)-Ib gene was performed to identify aac(6′)-Ib-cr variant. Thirty-two (80%) aminoglycoside resistant isolates were detected during disk-diffusion technique. The marked increase in MIC was observed between 256 – ≥2048μg/ml to amikacin. The most prevalent AME-genes were aac(6′)-Ib (37.5%), ant(2”)-Iaa (21.86) followed by ant(4′)-IIa(12.5%), aph(3”)-Ib (12.5%) andaac(3)-Ia (9.38%). The most frequent combination was aac(6′)-Ib + aac(3)-Ia+ant(2”)-Iaa and aac(6′)-Ib + ant(4′)-IIa + aph(3”)-Ib(2 strains) followed by aac(6′)-Ib + aac(3)-Ia(1 strain). Sequencing of aac(6′)-Ib gene in this study did not harbor aac(6′)-Ib-cr variant gene. The results of this study provide insight into the presence of high AME-genes among Proteus spp. in Bangladesh.Severe acute malnutrition (SAM) is the most severe form of protein energy malnutrition (PEM). Few studies found serum electrolyte, serum calcium level changes as important factors of poor outcome. Hypoglycemia is already established as a risk factor for death in severe acute malnutrition. Edema, diarrhea and vomiting are commonly present in severe acute malnutrition which has impact on electrolyte balance and blood sugar level in healthy children. Their impact in severe acute malnutrition is not clearly established. This cross sectional descriptive study was conducted in Department of Pediatrics, MMCH from March 2018 to October 2019 to estimate serum electrolyte, serum calcium and random blood sugar level in severe acute malnutrition and their relationship with edema, vomiting and diarrhea. Forty-one (41) cases of SAM were enrolled in this study. Test samples were collected before starting the treatment. Case record form was used to collect information. Cases were divided into Group A and Group B based on the detected early and treated accordingly.Biology retracts the article “Advantage of Species Diversification to Facilitate Sustainable Development of Aquaculture Sector” cited above […].

    Therapeutic drug monitoring (TDM) is routinely used for optimization of vancomycin therapy, because of exposure-related efficacy and toxicity, in addition to significant variability in pharmacokinetics, which leads to unpredictable drug exposure.

    The aim of this study was to evaluate target attainment and TDM of vancomycin in neonates.

    The authors conducted a retrospective study and collected data from medical records of all neonates who received vancomycin therapy in the neonatal intensive care unit between January 2019 and December 2019. The primary outcome was the proportion of vancomycin courses that reached target trough concentrations of 10-20 mg/L based on appropriate TDM samples collection. Secondary outcomes included proportion of courses with appropriate dose and dose frequency, and proportion of patients who achieved target concentrations after the first dose adjustment.

    In total, 69 patients were included, with 129 vancomycin courses. The median initial vancomycin trough concentration was 12 (range 4-36) mg/L. The target trough concentration was achieved in 75% of courses after the initial dose with appropriate TDM, and 84% of courses after TDM-guided dose adjustments. Patients were dosed appropriately in 121/129 courses and TDM was performed correctly according to protocol in 51/93 courses. A dose adjustment was performed in 18/29 courses, to increase target attainment.

    This study showed that there is a need for an increase in dose to improve target attainment. There is also a need to explore more effective TDM strategies to increase the proportion of neonatal patients attaining vancomycin target trough concentrations.

    This study showed that there is a need for an increase in dose to improve target attainment. There is also a need to explore more effective TDM strategies to increase the proportion of neonatal patients attaining vancomycin target trough concentrations.

    Both the Melbourne Rapid Fields (MRF) tablet and home versions are easy-to-use, portable, and low-cost and accurate methods of evaluating visual fields.

    This study aimed to investigate the clinical capabilities of the MRF perimetry test by comparing it with the Humphrey Field Analyzer (HFA), determine MRF consistency, assess the influence of refractive error, ascertain ambient illumination effects, and evaluate the consistency between the tablet and Internet Web site versions of the MRF.

    Forty healthy young participants with normal visual function (33 female, 7 male; average age, 24 years) underwent two MRF office-based tablet, two HFA tests, and two MRF Web site-based tests, one in our laboratory and one at home on their own computer using the 24-2 test pattern each time. An additional six healthy participants with normal visual function performed the 24-2 test with varying amounts of blur.

    The average individual sensitivity values of MRF and HFA were within 4.02 dB (right eye) and 4.15 dB (left eye). The dynamic range of the MRF was smaller (30 dB) than that of the HFA. When sensitivity values greater than 30 dB were excluded, the sensitivity differences were within 2.2 dB (right eye) and 2.46 dB (left eye) of each other. Only a small number of cases produced reliability values (false positives, false negatives, fixation losses) that were outside of normal limits. There was a high correlation between test results obtained with the tablet version of the MRF test when compared with the Internet-based Web site version.

    Quantitative visual field testing and perimetric screening procedures can be performed effectively and can provide results that are comparable with bowl perimeter test results.

    Quantitative visual field testing and perimetric screening procedures can be performed effectively and can provide results that are comparable with bowl perimeter test results.