Diabetes and hypertension in patients with psoriasis: a cross sectional and case control study in a tertiary care hospital of Bangladesh

Background: In this study our main goal was to evaluate the association of psoriasis as a risk predictor for the occurrence of diabetes mellitus (DM) and hypertension (HTN).Methods: This case control study was carried out in the department of dermatology and venereology, Chittagong medical college hospital (CMCH), Chittagong, Bangladesh from 15 June 2011 to 14 May 2012. Where 60 patients with psoriasis and 60 patients with skin diseases other than psoriasis were included according to availability within the study period.Results: During study, among the psoriatic patients, most of the patients with DM and HTN had body mass index (BMI) within normal limit. During analysis of different clinical findings in psoriatic patients scaling was present in all the cases followed by Auspitz sign, koebnerization, itching, scalp involvement and nail changes. Patients with psoriasis were found to have higher incidence of DM and HTN in comparison to their non-psoriatic control group. It was also observed that psoriatic patients having DM and HTN had longer duration of diseases (p<0.05).Conclusions: In conclusion, our study indicates that patients with psoriasis have an increased risk of DM and HTN, confirming the findings from previous several case control and cross sectional studies. These data illustrate the importance of considering psoriasis as a systemic disorder rather than simply a skin disease. Awareness of concurrent diseases will provide the clinician an opportunity of screening .for others systemic diseases

Transfusion-related acute lung injury in a paediatric intensive care unit of Pakistan

Background: Transfusion-Related Acute Lung Injury (TRALI) is a major cause of transfusionrelated morbidity and mortality in the intensive care unit setting. There is a paucity of such data from Pakistan. The purpose of this study is to assess the incidence and outcome of TRALI in critically ill children admitted in a pediatric intensive care unit (PICU) of Pakistan.Methods: This is a retrospective cohort study of all critically ill or injured children who developed TRALI or possible TRALI after blood transfusion based on Canadian Conference Consensus criteria in a closed multidisciplinary-cardiothoracic PICU from January 2012 to June 2016. The demographic, pertinent clinical data, transfusion-related variables and outcome of all cases of TRALI were recorded.Results: Of total 2975 admissions in the PICU during study period, 35.8% (1066) received 5124 blood components. Eleven cases developed TRALI in our cohort. The incidence of TRALI was 1.03% per patient transfused and 0.19% (19/100,000 per blood product transfused). Median age was 8 (range 1-14) yr., 70 % (n=8) were male. Mean PRISM-III score was 16.3±6.7. Mean time interval for onset of TRALI was 2.73±1.67 hr. The postoperative cardiac surgical and hematology-oncology patients were most common categories (63.6%). Plasma and platelets were the most commomly identified trigger of TRALI. The case-specific mortality was 63.6% and the overall mortality was 10.7% (p\u3c0.0001).Conclusions: The incidence of TRALI in critically ill children is low, but is associated with high mortality. Critically ill children with high PRISM-III score, postoperative cardiac surgical and hematology-oncology patients are often affected by TRALI

Clostridium Difficile Associated Diarrhea in Children with Hematological Malignancy-Experience from a Pediatric Oncologic Centre, Bangladesh

Background: Clostridium difficile Associated Diarrhea (CDAD) is considered to be one of the commonest causes of nosocomial diarrhoea worldwide. Gastrointestinal infections in the form of diarrhoea are common in pediatric oncology patients in Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh. The study was conducted to find out the frequency of Clostridium difficile infection (CDI) among diarrheal children with haematological malignancy. Materials and Methods: This prospective observational study was conducted from April 2012 to March 2013 at the Pediatric Hematology and Oncology Unit, BSMMU, Bangladesh. Total 58 diarrheal episodes occurred in 51 children with various types of haematological malignancies were included consecutively. Faecal samples of the children were sent to International Centre for Diarrheal Disease Research, Bangladesh (ICDDR, B) laboratory for detection of Clostridium difficile antigen (GDH) and toxins (A and/ or B) by Enzyme Immunoassay (EIA). Results: Among 58 diarrheal episodes 22.4% faecal samples were positive for GDH, but none of the faecal samples was positive for toxin A and or B. There were a significant association with leucopenia, severe neutropenia; usage of meropenem plus vancomycin, cefepime plus amikacin, imipenem, cytarabine and omeprazole with GDH positive diarrheal episodes. Conclusion: Positive GDH antigen with a negative result for toxin indicates C. difficile colonization. Among GDH positive episodes, a significantly higher proportion of children had leucopenia, severe neutropenia and usage of some drugs known as risk factors for C. difficile infection. To confirm the CDI advanced tests are needed

A 2-year-old male child with diffuse abdominal pain, mass in the abdomen and red currant jelly stool

This article has no abstract. The first 100 words appear below: A 2-year-old male child, the second issue of non-consanguineous parents, from average socio-economic status hailing from Dinajpur, Bangladesh was attended at Pediatric Surgery outpatient department with the complaints of vague diffuse abdominal pain in the lower right side of abdomen and around the umbilical region for last 3 days. His mother also reported the feeling of a solid mass in the abdomen during dressing of her child. Then, gradually his problems were increasing in nature with several times of nausea, vomiting, and the passage of blood mixed stool three times before his admission

Dose-response relationship between arsenic exposure and the serum enzymes for liver function tests in the individuals exposed to arsenic: a cross sectional study in Bangladesh

<p>Abstract</p> <p>Background</p> <p>Chronic arsenic exposure has been shown to cause liver damage. However, serum hepatic enzyme activity as recognized on liver function tests (LFTs) showing a dose-response relationship with arsenic exposure has not yet been clearly documented. The aim of our study was to investigate the dose-response relationship between arsenic exposure and major serum enzyme marker activity associated with LFTs in the population living in arsenic-endemic areas in Bangladesh.</p> <p>Methods</p> <p>A total of 200 residents living in arsenic-endemic areas in Bangladesh were selected as study subjects. Arsenic concentrations in the drinking water, hair and nails were measured by Inductively Coupled Plasma Mass Spectroscopy (ICP-MS). The study subjects were stratified into quartile groups as follows, based on concentrations of arsenic in the drinking water, as well as in subjects' hair and nails: lowest, low, medium and high. The serum hepatic enzyme activities of alkaline phosphatase (ALP), aspartate transaminase (AST) and alanine transaminase (ALT) were then assayed.</p> <p>Results</p> <p>Arsenic concentrations in the subjects' hair and nails were positively correlated with arsenic levels in the drinking water. As regards the exposure-response relationship with arsenic in the drinking water, the respective activities of ALP, AST and ALT were found to be significantly increased in the high-exposure groups compared to the lowest-exposure groups before and after adjustments were made for different covariates. With internal exposure markers (arsenic in hair and nails), the ALP, AST and ALT activity profiles assumed a similar shape of dose-response relationship, with very few differences seen in the higher groups compared to the lowest group, most likely due to the temporalities of exposure metrics.</p> <p>Conclusions</p> <p>The present study demonstrated that arsenic concentrations in the drinking water were strongly correlated with arsenic concentrations in the subjects' hair and nails. Further, this study revealed a novel exposure- and dose- response relationship between arsenic exposure metrics and serum hepatic enzyme activity. Elevated serum hepatic enzyme activities in the higher exposure gradients provided new insights into arsenic-induced liver toxicity that might be helpful for the early prognosis of arsenic-induced liver diseases.</p

Experimental study of hot spot cooling in micro-scale two phase system with wettability gradient

Thermal management is one of the most challenging problems of electronic devices today. As technology becomes increasingly miniaturized, it becomes difficult to keep devices away from overheating due to extremely localized heat dissipation. Two-phase cooling or flow-boiling in micro-spaces utilizes the highly efficient thermal energy transport of phase change from liquid to vapor. However, the excessive consumption of liquid-phase by highly localized heat source causes the two-phase flow maldistribution, leading to a greatly reduced heat transfer coefficient, high-pressure loss, and limited flow rate. In this study, we investigate two-dimensional flow-boiling in a microgap heat sink with different hydrophilic coating on hot-spot and characterize the bubble morphology, heat transfer, and pressure drop. The experiments are carried out on a Stainless Steel plate, having a micro gap depth of 170 [mu]m using deionized water with inlet at room temperature. A partial hydrophilic and a hydrophilic channel surfaces are created on the hot-spot (surface above the heater) to compare the thermal performance with the conventional surface. The relative thermal performance and wettability change between the hydrophilic surfaces are also evaluated. A wide range of heat flux varying from 91.35 KW/m2 to 118.25 KW/m2 and mass flux varying from 1.656 Kg/m2s to 4.97 Kg/m2s are considered to quantify heat transfer coefficient. From the high-speed flow visualizations, it is found that vapor films and slugs are flushed quickly from the hydrophilic surfaces, which improve heat transfer on hydrophilic heat sink compared to the conventional heat sink. It is also evaluated that among the hydrophilic heat sinks, channel hydrophilic heat sink shows better cooling performance and pressure stability as it provides a smooth route for the incoming water to cool the hot spot

Development of a systems approach to planning, design and operations of intermodal passenger transfer facilities to increase the mobility and safety of older travelers.

America, as a society, is aging. Currently, 13% of the population is 65 years of age or older. This percentage is expected to rise to 21% by 2030. Since older travelers frequently suffer from one or more age-related physical and/or information handling decrements, they often have problems using intermodal passenger transfer facilities. The overall goal of this study was to develop a framework which can provide an approach to identify older traveler issues associated with intermodal passenger transfer facilities and serve to guide planning and engineering improvements to intermodal passenger transfer facilities to increase the safety and mobility of older travelers. This objective was achieved by developing an older traveler plan (OTP) for intermodal passenger transfer facilities as a tool for transportation practitioners in real application on the basis of analyses of the results of an older traveler survey, information on a unique systems approach to older transportation in Waterloo, Iowa, and information from existing literature on older travel. Overall results of this study tended to confirm the hypothesis that a systems approach to planning, designing and operating an intermodal passenger transfer facility is appropriate to address the problems of older travelers. The older traveler plan (OTP) which includes a step-by-step approach, is a simple, effective tool which is expected to help support transportation planners and traffic engineers in planning, designing, implementing, operating, and maintaining intermodal passenger transfer facilities to increase the mobility and safety of older travelers. This was confirmed by a limited survey of transportation practitioner