Persisting non-albicans candidemia in low birth weight neonates in a tertiary care hospital, Jammu and Kashmir

Background: Neonatal candidemia is among the leading causes of mortality in neonatal intensive care units of the developing countries like India. This work aimed at determining the prevalence of candidemia, spectrum of disease, risk factors and the antifungal susceptibility in low birth weight neonates in neonatal intensive care unit (NICU)’s at a tertiary care level. Methods: This was a prospective cross-sectional study of blood culture positive candidemia cases in neonates admitted to the neonatal intensive care unit of tertiary care hospital, SMHS, Jammu and Kashmir, India, between July 2021 to December 2022. All neonates with a clinical suspicion of candidemia with a positive blood culture (BacT alert) were identified. Patient demographics, clinical details, neonatal risk factors, and laboratory data and antifungal susceptibilities (using VITEK 2 compact system) were recorded and analyzed. Results: A total of 680 neonatal blood culture samples were collected from NICU’s, out of which 88 (12.94%) developed candidemia. Low birth weight (33.33%), indwelling catheters (31.52%), prematurity (31.31%) and prolonged use of antibiotics were important risk factors. The commonest clinical manifestation was feed intolerance 66.1% and respiratory distress 62.2%. Non-albicans candida was seen in majority cases 86.36% with Candida krusei 77.27%. All the Candida spp. showed 100% sensitivity to voriconazole and caspofugin followed by amphotericin B, fluconazole and micafugin. Conclusions: In this study, we focussed on determining the prevalence of candidemia in low birth weight neonates. The persistently emerging non-albicans Candida particularly Candida krusei has emerged as a big concern and needs attention for its prevention and treatment to minimize the morbidity and mortality rate

Water safety plan: a commitment towards safe and sustainable water supplies

WaterAid Bangladesh (WAB) works in hard to reach difficult areas and promotes context specific, appropriate safe water supply options through its Partner NGOs. It is felt that community involvement is vital to maintain the quality of water–safe and to make these interventions sustainable. Water Safety Plan (WSP) approach involves community to actively participate in risk assessment and risk management activities by identifying potential risks for contamination of waterpoints, ensuring better operation & maintenance towards keeping water safe and handling water safely. WaterAid Bangladesh piloted WSP successfully and then scaled up in entire working areas. WAB has also built the capacity of staff, community and Local Government Institutions to execute their roles towards safe & sustainable water supply and improved hygienic behaviours. WAB addressed about half a million waterpoints out of ten million in the country by reaching almost 6 million beneficiaries

Responses and screening of white jute (Corchorus capsularis L.) genotypes against salinity stresses

Soil salinity, a serious threat to jute cultivation in saline areas (southern parts) of Bangladesh. Bangladesh Jute Research Institute (BJRI) has developed a moderately salt tolerant White Jute variety (BJRI Deshi pat-8; BJC 2197) in 2013 which can’t grow well in saline areas having more than 8.0 dSm-1 salinity stress. Hence, 23 whitejute accessions and one control variety (BJC 2197) were tested to isolate the salt tolerant accession(s) for hybridization purpose followed by augmented design in farmers’ field having nearly 8.0-9.0 dSm-1 salinity at Patuakhali district during mid-March to mid-August 2019. The experimental plot size was 3.0 m2 (3 m × 1 m) for each genotype having 3 lines of 1.0 m length, plant-plant: 10-15 cm and line- line: 30 cm distance. Soil salinity was recorded during sowing, vegetative and plant maturity stages. In this study, the highest plant height 2.84 m was recorded in Acc. 2750 followed by Acc. 2589 (2.76 m) and Acc. 1779 (2.69 m). The highest fiber yield (9.0 g plant-1) was observed in Acc. 1779 followed by Acc. 2589 (8.40 g plant-1) and Acc. 2750 (8.0 g plant-1). The lowest plant mortality rate (2.5%) was found in Acc.2750 followed by Acc.1779 (6.24%), Acc. 1780 (7.50), Acc. 3556 (11.10%), Acc. 2589 (11.20%) and BJC 2197 (16.5%). Few seeds were germinated in Acc. 3020 and Acc. 3658 but plants were died after 20 days of sowing. Six genotypes of cluster I showed higher diversity in Euclidean cluster analysis. The Acc. 2750, Acc. 1779, Acc. 2589 of cluster I having relative salinity tolerance and good fiber yield capacity would be grown in next year for confirmation as well as hybridization with the existing salinity susceptible variety to develop high yielding white jute variety for saline areas

The evaluation between vitamin D level and pelvic organ prolapse in post-menopausal women

Background: Vitamin D is important for skeletal integrity and optimal muscle function. The high incidence and prevalence of vitamin D deficiency and pelvic organ prolapse have been found in postmenopausal women, raising the question of whether the entities are related. The aim of the study was to evaluation between vitamin D level and pelvic organ prolapse in post-menopausal women. Methods: This case control study has been designed and conducted in the Department of Obstetrics and Gynecology, BSMMU to investigate the level of vitamin D in patients with and without pelvic organ prolapse to explore the association of vitamin D with pelvic organ prolapse. After taking informed written consent the serum vitamin D level of all participants was measured by CMIA technology with flexible assay protocols at Biochemistry and Molecular Biology department of the same institute. Statistical analysis of the results was obtained by using window-based computer software devised with Statistical Packages for Social Sciences (SPSS-24). Results: The study population was divided into two groups, a case group (n=74) consisting of patients with pelvic organ prolapse and a control group (n=74) comprising of women without pelvic organ prolapse. A total 148 participants of 52 years or older attending the out or inpatient department were enrolled in the study. Mean±SD level of Vitamin D in the case group was 13.96±5.18 ng/ml and in the control, group was 21.08±5.77 ng/ml respectively. The difference was statistically significant (p<0.05). Moreover, the vitamin D levels were inversely proportionate with the severity of pelvic organ prolapse. Conclusions: Vitamin D deficiency may be an important systemic factor associated with pelvic organ prolapse. Measuring vitamin D levels in postmenopausal women and replenishing deficiencies may also be important for the pelvic floor

Comparative outcome of cisplatin-capecitabine regimen with oxaliplatincapecitabine regimen in advanced gastric carcinoma: a quasi-experimental study

Chemotherapy is the primary therapeutic choice for advanced gastric cancer. The goal of this study was to assess the effectiveness and toxicity of the cisplatin-capecitabine regimen versus the oxaliplatin-capecitabine regimen in treating advanced gastric cancer. Between February 2021 and March 2022, this quasi-experimental study was conducted on 64 advanced gastric cancer patients. Purposive sampling was used to include those who met the inclusion criteria and distributed them evenly between the two arms. Arm A got an injection of cisplatin (80 mg/m2 on day 1) with oral capecitabine (1000 mg/m2 b.i.d. on days 1–14), whereas arm B received an injection of oxaliplatin (130 mg/m2 on day 1) plus oral capecitabine (1000 mg/m2 b.i.d. on days 1–14), every 3 weeks for 6 cycles. A final check-up was done at 12 weeks after the treatment. In arm A, 18 (56.2%) patients exhibited partial response compared to 15 (46.9%) in arm B. Stable diseases were also reported in both arms (18.8% in arm A and 21.9% in arm B). There were 8 (25.0%) cases of progressive disease in arm A and 10 (31.2%) cases in Arm B. The median progression-free survival in arms A (5.6 months) was almost similar to arm B (5.9 months). The most prevalent toxicities in both arms were vomiting, diarrhea, anemia, neutropenia, oral mucositis, paresthesia, handfoot syndrome, and renal toxicity. There were no statistically significant variations in outcomes between the two arms. In conclusion, the cisplatincapecitabine regimen is as effective as the oxaliplatin-capecitabine regimen in advanced gastric cancer. BSMMU J 2022; 15(3): 180-18

Construction of copy number variation landscape and characterization of associated genes in a Bangladeshi cohort of neurodevelopmental disorders

Introduction: Copy number variations (CNVs) play a critical role in the pathogenesis of neurodevelopmental disorders (NDD) among children. In this study, we aim to identify clinically relevant CNVs, genes and their phenotypic characteristics in an ethnically underrepresented homogenous population of Bangladesh. Methods: We have conducted chromosomal microarray analysis (CMA) for 212 NDD patients with male to female ratio of 2.2:1.0 to identify rare CNVs. To identify candidate genes within the rare CNVs, gene constraint metrics [i.e., “Critical-Exon Genes (CEGs)”] were applied to the population data. Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) was followed in a subset of 95 NDD patients to assess the severity of autism and all statistical tests were performed using the R package. Results: Of all the samples assayed, 12.26% (26/212) and 57.08% (121/212) patients carried pathogenic and variant of uncertain significance (VOUS) CNVs, respectively. While 2.83% (6/212) patients’ pathogenic CNVs were found to be located in the subtelomeric regions. Further burden test identified females are significant carriers of pathogenic CNVs compared to males (OR = 4.2; p = 0.0007). We have observed an increased number of Loss of heterozygosity (LOH) within cases with 23.85% (26/109) consanguineous parents. Our analyses on imprinting genes show, 36 LOH variants disrupting 69 unique imprinted genes and classified these variants as VOUS. ADOS-2 subset shows severe social communication deficit (p = 0.014) and overall ASD symptoms severity (p = 0.026) among the patients carrying duplication CNV compared to the CNV negative group. Candidate gene analysis identified 153 unique CEGs in pathogenic CNVs and 31 in VOUS. Of the unique genes, 18 genes were found to be in smaller (<1 MB) focal CNVs in our NDD cohort and we identified PSMC3 gene as a strong candidate gene for Autism Spectrum Disorder (ASD). Moreover, we hypothesized that KMT2B gene duplication might be associated with intellectual disability. Conclusion: Our results show the utility of CMA for precise genetic diagnosis and its integration into the diagnosis, therapy and management of NDD patients

Splinters in the Citizenship of India, Legality, and Social Trauma: National Register of Citizens

10.1080/08865655.2022.2115389Journal of Borderlands Studies384637-65

Mechanistic role of boswellic acids in Alzheimer's disease:Emphasis on anti-inflammatory properties

The resin/gum of Boswellia species belonging to the family of Burseraceae is a naturally occurring mixture of bioactive compounds, which was traditionally used as a folk medicine to treat conditions like chronic inflammation. Several research studies have also explored its’ therapeutic potential against multiple neurodegenerative diseases such as Alzheimer’s disease (AD). The main chemical constituents of this gum include boswellic acids (BAs) like 3-O-acetyl-11-keto-β boswellic acid (AKBA) that possess potent anti-inflammatory and neuroprotective properties in AD. It is also involved in inhibiting the acetylcholinesterase (AChE) activity in the cholinergic pathway and improve choline levels as well as its binding with nicotinic receptors to produce anti-inflammatory effects. Multiple shreds of evidence have demonstrated that BAs modulate key molecular targets and signalling pathways like 5-lipoxygenase/cyclooxygenase, Nrf2, NF-kB, cholinergic, amyloid-beta (Aβ), and neurofibrillary tangles formation (NFTs) that are involved in AD progression. The present review focuses on the possible mechanistic therapeutic role of BAs in modulating the 5-LOX/COX pathway in arachidonic acid metabolism, activating Nrf2 through binding of ARE, inhibiting NF-kB and AChE activity. In addition, an inhibition of amyloid plaques (Aβ) and neurofibrillary tangles (NFTs) induced neurotoxicity and neuroinflammation in AD by BAs is also discussed in this review. We have also highlighted that BAs possess beneficial effects in AD by targeting multiple molecular pathways and makes it an emerging drug candidate for treating neurodegenerative diseases

Comparative outcome of cisplatin-capecitabine regimen with oxaliplatincapecitabine regimen in advanced gastric carcinoma: a quasi-experimental study: Comparative outcome of cisplatin-capecitabine regimen with oxaliplatin-capecitabine regimen in advanced gastric carcinoma

Chemotherapy is the primary therapeutic choice for advanced gastric cancer. The goal of this study was to assess the effectiveness and toxicity of the cisplatin-capecitabine regimen versus the oxaliplatin-capecitabine regimen in treating advanced gastric cancer. Between February 2021 and March 2022, this quasi-experimental study was conducted on 64 advanced gastric cancer patients. Purposive sampling was used to include those who met the inclusion criteria and distributed them evenly between the two arms. Arm A got an injection of cisplatin (80 mg/m2 on day 1) with oral capecitabine (1000 mg/m2 b.i.d. on days 1–14), whereas arm B received an injection of oxaliplatin (130 mg/m2 on day 1) plus oral capecitabine (1000 mg/m2 b.i.d. on days 1–14), every 3 weeks for 6 cycles. A final check-up was done at 12 weeks after the treatment. In arm A, 18 (56.2%) patients exhibited partial response compared to 15 (46.9%) in arm B. Stable diseases were also reported in both arms (18.8% in arm A and 21.9% in arm B). There were 8 (25.0%) cases of progressive disease in arm A and 10 (31.2%) cases in Arm B. The median progression-free survival in arms A (5.6 months) was almost similar to arm B (5.9 months). The most prevalent toxicities in both arms were vomiting, diarrhea, anemia, neutropenia, oral mucositis, paresthesia, handfoot syndrome, and renal toxicity. There were no statistically significant variations in outcomes between the two arms. In conclusion, the cisplatincapecitabine regimen is as effective as the oxaliplatin-capecitabine regimen in advanced gastric cancer. BSMMU J 2022; 15(3): 180-18