Maternal risk factors and short term outcome of prematurity: A descriptive study at a secondary care hospital

Background: Approximately 15 million babies are born premature (before 37 weeks of gestation) and 1 million babies die due to prematurity complications every year. Less is known about risk factors of prematurity in middle and low-income countries. The prevalence of prematurity ranges from 5% - 18%. Objective: To determine the prevalence of premature births and to assess the rate of survival, along with the morbidity, among preterm newborns. Furthermore, to document our experience with different gestational age groups of preterm births; and to analyze the association among these strata and their clinical outcomes. Study Design: A descriptive study. Place and Duration of Study: The Aga Khan Maternal and Childcare Centre Hyderabad, Pakistan, from 1st January 2017 to 31st December 2018. Methodology: All pregnant women registered at the obstetric clinic before 24 weeks of gestation having at least three subsequent visits at the same clinic were included in the study. The women who were lost to follow up before completing three visits were excluded from the study. All un-booked women were also excluded from the study. Demographic profile was recorded including maternal age, parity, no of visits at the clinic, gestational age, mode of delivery, birth weight and pregnancy outcome. Newborns were subsequently followed at nursery or well-baby till discharge. Further subgroups were made for gestational age to assess the frequency of various morbidities in each group. Results: One thousand and ninety-one (1091) women were included in the study period that fulfilled the inclusion criteria. Two pregnancies were terminated before 24 weeks due to major congenital malformations. The prevalence of prematurity was recorded as 13.4% (146/1089). Perinatal mortality rate (no of stillbirths plus the number of early neonatal death/1000 live birth) was 17 (15.6/1000 live births) out of them, 12 were still births and 5 were early neonatal death. Out of the total preterm babies born, 59.5% (87/146) were admitted to the nursery. In the study group (2%/3146) were extreme preterm, while 7.5% were severe preterm (11/146). Moderate preterm was 11.6% (17/146) and the majority were late preterm accounting for 78.7% (115/146). Though the incidence of birth asphyxia were noted more in late preterm babies i.e. 10 as the number of these babies are also high in our study but the overall percentage was low (8.7%) as compared with the babies of extreme prematurity (100%) and moderate late prematurity (23.5%) respectively. In pregnancy outcome, 12 were still births in which six (50%) were in the late preterm group. Total of 17 newborns suffered from birth asphyxia in which ten newborns (58.8%) were in late preterm group. Overall, it was noted that the decreasing gestational age was directly correlated to morbidity and mortality. Conclusion: Among the different strata, the late preterm group has been observed to be associated with greater morbidity and mortality. Prior awareness of the morbidities associated with late preterm babies is helpful for the health care providers to anticipate and manage potential complications in preterm infants

The Challenges Faced By Dental Students in Studying Oral Pathology Online During Covid-19: A Cross-Sectional Study

OBJECTIVES The way of practising and teaching dentistry has changed significantly worldwide due to the COVID-19 pandemic, and the impact on dental education should not be neglected. Therefore, sharing experiences about online teaching from in-person education is essential to a better learning process during this period. This study aimed to assess the challenges faced by dental students in studying oral pathology online during covid-19: a cross-sectional study. METHODOLOGY It was a descriptive cross-sectional study in the Department of oral pathology at Altamash Institute of dental medicine to assess the challenges students faced during the COVID-19 pandemic. A total of 110 participants were approached, and among them, 105 participants responded. Of 105 participants, 78% were females, and 22% were males. Data were analyzed using SPSS version 23.RESULTSAlmost 93.3% of the students felt in-person lectures are more effective than online lectures. Fourth-year students showed higher satisfaction with the number of online tutorial / practical classes taken to provide an in-depth view of the subject than 3rd year students (8.8% vs 91.2%, p=0.045). Fourth-year students showed significantly higher satisfaction with several online theory classes to provide an in-depth view of the subject than 3rd year students (p=0.045). CONCLUSION The present study concluded that most students prefer in person classes over virtual learning and face a lack of online interaction with the faculty.

Adaptive Backstepping Integral Sliding Mode Control for 5DOF Barge-Type OFWT under Output Constraint

This article presents a new control solution for a dynamical model of a translational oscillator with a rotational actuator (TORA) based on multi-body dynamics for a barge-type offshore floating wind turbine (OFWT). TORA has been employed as an active structural control strategy. The solution of bounding the output movements of platform pitch and tower bending angle to a certain limit, along with mitigating the OFWT vibrations due to environmental disturbances and uncertainties, is presented in this novel control framework. This new control algorithm consists of a high-gain observer (HGO)-based adaptive backstepping integral sliding mode control (ISMC) and a barrier Lyapunov function (BLF). This guarantees satisfying the constraints on the states and effectively resolves the problem of the unavailability of the system states. The proposed control law based on the BLF has been compared with an adaptive backstepping ISMC to show the efficiency of the output-constraint control scheme. Through MATLAB/SIMULINK numerical simulations and their numeric error table, the effectiveness of the proposed control scheme has been examined. The results confirm the validity and efficiency of the proposed control approaches

Urinary tract infection and their risk factors association in renal transplant recipients

Background: Urinary tract infection (UTI) remains one of the most common and major complications after renal transplantation. Objective: The study was undertaken to get an insight regarding the bacterial pathogen which is responsible for UTI in post renal transplant patients and their risk factors association. Methods: This was an observational study, conducted in the Department of Microbiology and Immunology Bangabandhu Sheikh Mujib Medical University (BSMMU) from December 2010 to December 2011. Twenty- one renal transplant recipients were evaluated for UTl after surgery up to six weeks. Microscopic examination and culture of urine were performed in every pre-transplant period, 3rd POD, 7th POD, within six weeks and as per patient's clinical condition. UTI was considered when bacterial count wa

Clinico-Pathological Findings in Myeloid Malignancies: A Single Center Experience

INTRODUCTION: Myeloid malignancies are clonal disorders of hematopoietic stem/precursor cells. The criteria for the diagnosis of acute myeloid leukemia (AML) are based on morphological cytogenetic and flow-cytometric findings. The prognostic outcome with intensive chemotherapy is better than with non-intensive treatment. PURPOSE/OBJECTIVES: To determine the frequency of various clinical & pathological findings in myeloid malignancies. STUDY DESIGN: Cross sectional descriptive study. PLACE AND DURATION OF STUDY: The study was carried out at Department of Pathology from October 2014 to December 2016. MATERIAL/PATIENTS AND METHODS: Detailed history, clinical and pathological findings recorded on a pre-designed proforma including bone marrow reports was evaluated. RESULTS: During period of study, 351 proformas including bone marrow reports were evaluated, from which 49 (30 males and 19 females; age ranges between 03 months to 60 years) were diagnosed as myeloid malignancies. The distribution of myeloid malignancies were acute myeloid leukemia (n=21), chronic myeloid leukemia (n=14), acute myelodysplastic syndrome (n=3), myeloproliferative neoplasms (n=3), myelofibrosis (n=2), myeloid hyperplasia (n=2), acute promyelocytic leukemia (n=2), myelomonocytic leukemia (n=1), ,and transient abnormal myelopoiesis (n=1).The main presenting complaints were fever and weight loss, whereas splenomegaly was the most common finding on clinical examination. The commonest laboratory finding was anemia followed by leukocytosis; while 10 patients showed pancytopenia. CONCLUSION: AML with fever and bicytopenia is the commonest myeloid malignancy in our series

Comparison of combined disc synergy test and double disc synergy test for phenotypic detection of metallo-ß-lactamase among the clinical isolates of gram-negative bacilli

Background: Metallo-β-lactamases (MBL) have a wide spectrum of activity and they confer a higher level of resistance to all β-lactams antibiotics including Carbapenem. The active site in MBLs contains either 1 or 2 Zn2+ ions for their catalytic mechanism. All MBLs share a common feature of being inhibited by EDTA. Metallo-β-lactamase-producing gram-negative bacteria are the most important nosocomial pathogens. The present study was conducted to detect Metallo-β-lactamase (MBL) production in gram-negative bacilli by Combined Disc Synergy Test (CDST) and Double Disc Synergy Test (DDST) with 0.1M EDTA as a chelator and to see their antibiotic susceptibility pattern of them.Methods: The cross-sectional observational study was carried out in the Department of Microbiology, Chittagong Medical College, during the period of July 2015 to June 2016. Samples were collected from patients admitted to CMCH. Standard Microbiological procedures and biochemical tests were carried out for the isolation and identification of MBL. SPSS software is used for data analysis.Results: When 66 screening positive MBL isolates were subjected to the phenotypic confirmatory test CDST detected 50 (25.4%) and DDST detected 48 (24.4%) as MBL producers. Among these isolates, we found Acinetobacter spp. 7 (100%), as the leading MBL producer followed by Pseudomonas spp. 16 (32.6%), E. coli 10 (20%) and Klebsiella spp. 15 (17.4%).Conclusions: In a laboratory where multiplex PCR molecular set-up is not available CDST and DDST are convenient phenotypic methods and can be implemented in routine microbiological laboratories as well as in primary health care setup for daily application to monitor the production of MBLs

Miller Fisher Variant of Guillain-Barré Syndrome: A Case Report & Clinical Review

Miller Fisher syndrome (MFS) is an uncommon variant of Guillain-Barré syndrome (GBS). It is characterized by external ophthalmoplegia, ataxia, and areflexia. The incidence of MFS as a proportion of GBS was reported to be 1 to 5 % in western countries and considerably higher in Eastern Asia i.e. 19% in Taiwan and 25% in Japan. Here we report the clinical features of a patient who initially presented with ataxia then subsequently developed limb weakness, areflexia and ophthalmoplegia. CSF study and NCV study supported our clinical diagnosis. Patient was managed conservatively. No intravenous immunoglobulin was given but the patient gradually improved in symptoms including power, ataxia, ophthalmoparesis. After one month the patient was discharged from hospital with complete recovery.DOI: http://dx.doi.org/10.3329/bsmmuj.v5i1.11028 BSMMU J 2012; 5(1):69-71

The possible therapeutic role of curcumin and quercetin in the early-stage of COVID-19—Results from a pragmatic randomized clinical trial

BackgroundCurcumin (CUR) and quercetin (QUE), two natural polyphenols, possess diverse biological activities including broad-spectrum antiviral, antioxidant, and immunomodulatory effects. Both CUR and QUE have shown inhibition of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in in vitro assays.ObjectiveIn the present study we aimed to assess the possible treatment benefits of a combined curcumin and quercetin (CUR-QUE) oral supplement, alongside standard of care (SOC), in the early-stage COVID-19 infection.MethodsThis was an exploratory, pragmatic, open-label, randomized controlled clinical trial, conducted at the Department of Pathology, Liaquat University of Medical and Health Sciences, Jamshoro, PK. The study compared the treatment effect of an oral CUR-QUE supplement plus SOC vs. SOC alone, in the early-stage/mild to moderately symptomatic COVID-19 outpatients. Patients were randomized in a 1:1 ratio to CUR-QUE (n = 25) and control (n = 25) treatment groups. The CUR-QUE supplementation consisted of a daily intake of 168 mg curcumin and 260 mg quercetin, as two soft capsules, to be taken twice a day at home for 14 days.ResultsAfter one-week of treatment, most of the patients in the CUR-QUE group showed an expedited clearance of the viral infection i.e., 18 (72.0%) vs. 6 (24.0%) patients in the control group tested negative for SARS-CoV-2 in the nasal-oropharyngeal swab reverse transcription-polymerase chain reaction (RT-PCR) analysis (p = 0.0002). In addition, COVID-19-associated acute symptoms were also speedily resolved in the CUR-QUE treated patients, i.e., 10 (40.0%) vs. 4 (16.0%) patients in the control group (p = 0.061). The CUR-QUE supplementation therapy was well-tolerated by all 25 patients and no treatment-emergent effects or serious adverse events were reported.ConclusionThe results revealed in this exploratory study suggest a possible therapeutic role of curcumin and quercetin in the early-stage of COVID-19. It is proposed that the two agents possibly acting in synergy, interfere the SARS-CoV-2 replication, and thus help a speedy recovery in the early-stage of COVID-19. Further research is highly encouraged.Clinical trial registrationClinicaltrials.gov, Identifier NCT04603690

Production of Nano Hydroxyapatite and Mg-Whitlockite from Biowaste-Derived Products via Continuous Flow Hydrothermal Synthesis: A Step towards Circular Economy

Biowastes from agriculture, sewage, household wastes, and industries comprise promising resources to produce biomaterials while reducing adverse environmental effects. This study focused on utilising waste-derived materials (i.e., eggshells as a calcium source, struvite as a phosphate source, and CH3COOH as dissolution media) to produce value-added products (i.e., calcium phosphates (CaPs) derived from biomaterials) using a continuous flow hydrothermal synthesis route. The prepared materials were characterised via XRD, FEG-SEM, EDX, FTIR, and TEM analysis. Magnesium whitlockite (Mg-WH) and hydroxyapatite (HA) were produced by single-phase or biphasic CaPs by reacting struvite with either calcium nitrate tetrahydrate or an eggshell solution at 200 °C and 350 °C. Rhombohedral-shaped Mg-WH (23–720 nm) along with tube (50–290 nm diameter, 20–71 nm thickness) and/or ellipsoidal morphologies of HA (273–522 nm width) were observed at 350 °C using HNO3 or CH3COOH to prepare the eggshell and struvite solutions, and NH4OH was used as the pH buffer. The Ca/P (atomic%) ratios obtained ranged between 1.3 and 1.7, indicating the formation of Mg-WH and HA. This study showed that eggshells and struvite usage, along with CH3COOH, are promising resources as potential sustainable precursors and dissolution media, respectively, to produce CaPs with varying morphologies

Production of nano hydroxyapatite and Mg-Whitlockite from biowaste-derived products via continuous flow hydrothermal synthesis : a step towards circular economy

Biowastes from agriculture, sewage, household wastes, and industries comprise promising resources to produce biomaterials while reducing adverse environmental effects. This study focused on utilising waste-derived materials (i.e., eggshells as a calcium source, struvite as a phosphate source, and CH3COOH as dissolution media) to produce value-added products (i.e., calcium phosphates (CaPs) derived from biomaterials) using a continuous flow hydrothermal synthesis route. The prepared materials were characterised via XRD, FEG-SEM, EDX, FTIR, and TEM analysis. Magnesium whitlockite (Mg-WH) and hydroxyapatite (HA) were produced by single-phase or biphasic CaPs by reacting struvite with either calcium nitrate tetrahydrate or an eggshell solution at 200 °C and 350 °C. Rhombohedral-shaped Mg-WH (23–720 nm) along with tube (50–290 nm diameter, 20–71 nm thickness) and/or ellipsoidal morphologies of HA (273–522 nm width) were observed at 350 °C using HNO3 or CH3COOH to prepare the eggshell and struvite solutions, and NH4OH was used as the pH buffer. The Ca/P (atomic%) ratios obtained ranged between 1.3 and 1.7, indicating the formation of Mg-WH and HA. This study showed that eggshells and struvite usage, along with CH3COOH, are promising resources as potential sustainable precursors and dissolution media, respectively, to produce CaPs with varying morphologies