Clinicopathological Spectrum and Treatment Outcome of Clinically Suspected Rapidly Progressive Glomerulonephritis: An Analysis of 35 Cases in a Tertiary Care Center, Bangladesh

Background and Aim: Rapidly progressive glomerulonephritis (RPGN) is characterized by a rapid decline in the renal function and urinary abnormalities. There is limited information on epidemiological factors and clinical and histopathological patterns of RPGN from developing countries. Therefore, the objective of this study was to identify the etiology, clinical features, histopathological patterns, and treatment outcomes of patients with clinically suspected RPGN. Methods: This retrospective study was conducted in the Pediatric Nephrology Department of Bangabandhu Sheikh Mujib Medical University from January 2014 to January 2019. Patients with clinically suspected RPGN that underwent renal biopsy were enrolled in this study. Results: Thirty-five patients were recruited in this study. Macroscopic hematuria, edema, hypertension, uremia, and oliguria were common clinical presentations. Diffuse proliferative GN (28.5%) and crescentic GN (22.8%) were the most common histological diagnoses in this study. Immune mediated GN (62%) followed by idiopathic GN (25%) were found to be the most frequent cause of crescentic GN. Renal replacement therapy was required in 45% of the cases and 11.4% of the patients developed end-stage renal disease.Conclusion: Renal histology is an integral part of the investigation of patients with suspected RPGN for both diagnostic and prognostic purposes. Diffuse proliferative GN was the most common histopathological diagnosis in patients with clinical RPGN in our population. Preservation of renal function depends on early intervention and detection of RPGN in pediatric patients.Keywords: Nephritis; Glomerulonephritis; ESRD; End-Stage Kidney Disease; Child.

Treatment Options of Temporomandibular Joint Ankylosis at a Tertiary Level Hospital in Bangladesh: A Two-Year Retrospective Analysis

Introduction: The study compares the surgical treatment options utilized to treat temporomandibular joint ankylosis at a tertiary level hospital in Bangladesh from 2016 to 2017. Materials and Methods: In this retrospective analysis, 18 patients (28 joints) were studied. History, radiological and physical examinations, and mouth opening were all part of the preoperative and postoperative evaluation. Age, sex, underlying cause, affected joint (s), surgery modality, complications, and follow-up durations were all taken into consideration. The data was analyzed using the SPSS 22.0 statistical software. The degree of mouth opening before and after different surgical techniques in different patient categories was compared using a one-way ANOVA followed by Tuky's HSD test. Results: Temporomandibular joint ankylosis was found to be in several forms (fibrous, fibro-osseous, and osseous), with trauma (61.11%) being the most common cause. The patients ranged in age from 5 to 30 years old, with females accounting for 55.55% of the total. The mean mouth opening significantly increased from 3.11 mm pre-operatively to 31.17 mm in the first month following surgery (p = 0.00001). In 55.55% of the instances, temporary facial nerve paresis occurred. Conclusions: Temporomandibular joint ankylosis can be successfully managed with early excision of the ankylotic mass, restoration of the ramus height by bone grafting, interpositional arthroplasty, and intensive physiotherapy

Effects of iron supplements and iron-containing micronutrient powders on the gut microbiome in Bangladeshi infants: a randomized controlled trial

Anemia is highly prevalent globally, especially in young children in low-income countries, where it often overlaps with a high burden of diarrheal disease. Distribution of iron interventions (as supplements or iron-containing multiple micronutrient powders, MNPs) is a key anemia reduction strategy. Small studies in Africa indicate iron may reprofile the gut microbiome towards pathogenic species. We seek to evaluate the safety of iron and MNPs based on their effects on diversity, composition, and function of the gut microbiome in children in rural Bangladesh as part of a large placebo-controlled randomized controlled trial of iron or MNPs given for 3 months (ACTRN12617000660381). In 923 infants, we evaluate the microbiome before, immediately following, and nine months after interventions, using 16S rRNA gene sequencing and shotgun metagenomics in a subset. We identify no increase in diarrhea with either treatment. In our primary analysis, neither iron nor MNPs alter gut microbiome diversity or composition. However, when not adjusting for multiple comparisons, compared to placebo, children receiving iron and MNPs exhibit reductions in commensal species (e.g., Bifidobacterium, Lactobacillus) and increases in potential pathogens, including Clostridium. These increases are most evident in children with baseline iron repletion and are further supported by trend-based statistical analyses

Exploring SAARC's ocean energy potential: Current status and future policies

Ensuring green, affordable, and available electricity is a challenge in the aftermath of the coronavirus pandemic. Meeting the criteria of Sustainable Development Goal 7 (SDG 7) and the pledges made at the Conference of Parties (COPs) is proving difficult for countries worldwide. Despite this, the untapped potential of the ocean as a readily available and reliable energy source remains largely unexplored. The South Asian Association for Regional Cooperation (SAARC) has been significantly impacted by energy crises. Surprisingly, countries in this area, despite having ocean renewable energy (ORE) potential, have been slow to embrace this option. This review focuses on summarizing the efforts and estimating the ORE potential in South Asia. It examines the future energy policies and plans of these countries in line with SDG 7 and COP commitments while also analyzing the barriers and drivers for ORE utilization. The review estimates that five SAARC nations have a wave energy reserve of over 41 GW, a tidal energy reserve of 8 GW, and an ocean thermal energy reserve of 31 GW. However, no studies have been conducted to estimate the salinity gradient energy. Academic and non-academic involvement in the sector is scarce in the region, and available data show inconsistencies. This work provides an overview of the current state of ocean energy research in and around the Indian Ocean, benefiting future researchers exploring the ORE potential of SAARC

Genetic analyses of truncated variant rs200185429 in ZNT8 encoding SLC30A8 gene with respect to prediabetes and type 2 diabetes in Bangladeshi population

Zinc transporter ZnT8, encoded by SLC30A8, is expressed highly in pancreatic β-cells that effluxes Zn2+ into insulin granules which is required to secret insulin from the granules. Genome-wide association study identified twelve loss of function mutations in SLC30A8 that play protective role against type 2 diabetes (T2D). This study aimed to find genetic association of a protein truncating variant rs200185429 in Bangladeshi healthy individuals (n = 184), patients with prediabetes (n = 130) and patients with T2D (n = 179). Genetic association study with respect to rs200185429 was performed using TaqMan® probe followed by allelic discrimination plots. Wild type CC genotype was found to be evenly distributed in healthy individuals (96.2 %), patients with prediabetes (95.38 %) and patients with T2D (94.41 %). CT genotype was more prevalent in T2D (5.59 %), less in healthy individuals (3.38 %). However, TT genotype was absent in the study participants. Mutant T allele was neither associated with prediabetes (OR = 1.22, χ2 = 0.12, p = 0.72) nor with T2D (OR = 1.42, χ2 = 0.52, p = 0.47). Similarly, none of the genetic inheritance models showed statistically significant association with T2D. Thus, a large-scale study is warranted to establish our finding regarding the association of rs200185429 with prediabetes and T2D in Bangladeshi population

Hair, serum and urine chromium levels in children with cognitive defects: A systematic review and meta-analysis of case control studies.

Environmental chromium exposure may cause impaired development of children. We conducted a systematic review and meta-analysis. Electronic databases including PubMed, Embase, Web of Science and CINAHL were searched to identify case-control studies that reported childhood Cr exposure and cognitive development. The Newcastle-Ottawa Scale (NOS) was used to ensure the quality of the included studies. Cr levels were compared in cases and controls, and a random effect meta-analysis was performed using Stata version 16. Twelve of 61 studies identified in the literature search were eligible for this analysis. Hair, serum and urine Cr measurements were reported by seven, two and one studies, respectively. In addition, one study reported both serum and hair Cr exposure and another reported urine and hair Cr exposure. The pooled standard mean differences (SMD) showed that hair Cr levels were non-significantly lower among children with cognitive defects (-0.01 μg/g, 95% CI: -0.04, 00, p = 0.27). In serum and urine, the pooled SMD was higher in children with cognitive deficits compared with healthy control children (0.32 μg/g, 95% CI: -0.78, 1.42, p = 0.56 and 0.64 μg/g, CI: -0.07,1.36, p = 0.08; respectively). In summary, this systematic review found no significant differences in hair, serum and urine Cr levels between children with cognitive deficits and healthy control children when all study data were pooled in the meta-analysis. Larger studies using standardized criteria and longitudinal assessment of cognitive development are needed to determine whether there is a dose response effect of childhood Cr exposure on cognitive development of children

Anti-Ascaris immunoglobulin E associated with bronchial hyper-reactivity in 9-year-old rural Bangladeshi children

AbstractBackgroundStudies have addressed the immunomodulatory effects of helminths and their protective effects upon asthma. However, anti-Ascaris IgE has been reported to be associated with an increased risk of asthma symptoms. We examined the association between serum levels of anti-Ascaris IgE and bronchial hyper-responsiveness (BHR) in children living in rural Bangladesh.MethodsSerum anti-Ascaris IgE level was measured and the BHR test done in 158 children aged 9 years selected randomly from a general population of 1705 in the Matlab Health and Demographic Surveillance Area of the International Centre for Diarrhoeal Disease Research, Bangladesh. We investigated wheezing symptoms using a questionnaire from the International Study of Asthma and Allergies in Childhood. BHR tests were successfully done on 152 children (108 ‘current wheezers’; 44 ‘never-wheezers’). We examined the association between anti-Ascaris IgE level and wheezing and BHR using multiple logistic regression analyses.ResultsOf 108 current-wheezers, 59 were BHR-positive; of 44 never-wheezers, 32 were BHR-negative. Mean anti-Ascaris IgE levels were significantly higher (12.51 UA/ml; 95% confidence interval (CI), 9.21–17.00) in children with current wheezing with BHR-positive than in those of never-wheezers with BHR-negative (3.89; 2.65–5.70; t test, p < 0.001). A BHR-positive test was independently associated with anti-Ascaris IgE levels with an odds ratio (OR) = 7.30 [95% CI, 2.28–23.33], p = 0.001 when adjusted for total IgE, anti-Dermatophagoides pteronyssinus IgE, pneumonia history, parental asthma, Trichuris infection, forced expiratory volume in one second, eosinophilic leukocyte count, and sex.ConclusionsAnti-Ascaris IgE level is associated with an increased risk of BHR among 9-year-old rural Bangladeshi children

Mutation Spectrum in TPO Gene of Bangladeshi Patients with Thyroid Dyshormonogenesis and Analysis of the Effects of Different Mutations on the Structural Features and Functions of TPO Protein through In Silico Approach

Although thyroid dyshormonogenesis (TDH) accounts for 10-20% of congenital hypothyroidism (CH), the molecular etiology of TDH is unknown in Bangladesh. Thyroid peroxidase (TPO) is most frequently associated with TDH and the present study investigated the spectrum of TPO mutations in Bangladeshi patients and analyzed the effects of mutations on TPO protein structure through in silico approach. Sequencing-based analysis of TPO gene revealed four mutations in 36 diagnosed patients with TDH including three nonsynonymous mutations, namely, p.Ala373Ser, p.Ser398Thr, and p.Thr725Pro, and one synonymous mutation p.Pro715Pro. Homology modelling-based analysis of predicted structures of MPO-like domain (TPO142-738) and the full-length TPO protein (TPO1-933) revealed differences between mutant and wild type structures. Molecular docking studies were performed between predicted structures and heme. TPO1-933 predicted structure showed more reliable results in terms of interactions with the heme prosthetic group as the binding energies were -11.5 kcal/mol, -3.2 kcal/mol, -11.5 kcal/mol, and -7.9 kcal/mol for WT, p.Ala373Ser, p.Ser398Thr, and p.Thr725Pro, respectively, implying that p.Ala373Ser and p.Thr725Pro mutations were more damaging than p.Ser398Thr. However, for the TPO142-738 predicted structures, the binding energies were -11.9 kcal/mol, -10.8 kcal/mol, -2.5 kcal/mol, and -5.3 kcal/mol for the wild type protein, mutant proteins with p.Ala373Ser, p.Ser398Thr, and p.Thr725Pro substitutions, respectively. However, when the interactions between the crucial residues including residues His239, Arg396, Glu399, and His494 of TPO protein and heme were taken into consideration using both TPO1-933 and TPO142-738 predicted structures, it appeared that p.Ala373Ser and p.Thr725Pro could affect the interactions more severely than the p.Ser398Thr. Validation of the molecular docking results was performed by computer simulation in terms of quantum mechanics/molecular mechanics (QM/MM) and molecular dynamics (MD) simulation. In conclusion, the substitutions mutations, namely, p.Ala373Ser, p.Ser398Thr, and p.Thr725Pro, had been involved in Bangladeshi patients with TDH and molecular docking-based study revealed that these mutations had damaging effect on the TPO protein activity