Frequency and pattern of congenital heart defects among admitted patient in a tertiary care hospital in Bangladesh

Background: Congenital heart disease (CHD) is the commonest of all congenital lesions accounting for nearly 28% of all congenital malformations that have significant impact on morbidity, mortality and heath care cost in children. The aim of study was to determine the pattern of distribution of CHD and the age at which initial diagnosis of CHD was made among children admitted under paediatric cardiology department, Bangladesh Shishu hospital and institute. Methods: This is a descriptive and prospective hospital-based study conducted in the pediatric cardiology department, Bangladesh Shishu hospital and institute. This study included all the patients admitted during January-June 2022 in pediatric cardiology department having confirmed diagnosis of CHD on basis of echocardiographic report. The collected data was entered and analyzed by using statistical package for social sciences v 24.0. Results: Out of 337 patient, 175 patient were male (51.9%) and 162 female (48.1%) with male female ratio of 1.08:1. Total 219 cases (64.9%) were acyanotic CHD and 118 (35.1%) were cyanotic congenital heart lesions. In acyanotic CHD ventricular septal defects (VSDs) constitute 38.8% followed by AV canal defect 6.7%, patent ductus arteriosus (PDA) 3.6%. In cyanotic CHD tetralogy of Fallot (TOF) was the commonest lesion accounted for 28 (8.3%) followed by d-transposition of great arteries 16 (4.7%), pulmonary atresia 15 (4.5%), total anomalous pulmonary venous circulation TAPVC 11 (3.3%), tricuspid atresia 9 (2.7%) and DORV, VSD, PS 10 (2.9%). The commonest combination was VSD with ASD in 15 cases (4.5%). Most of the patient was diagnosed in 1st year of age 280 (83.1%) Conclusions: CHD are very common in our setup and early detection of CHD is increasing. Overall burden of CHD is also increasing therefore a proper population-based study on a large scale is needed to estimate the prevalence accurately

Conversion of lignocellulosic corn agro-waste into cellulose derivative and its potential application as pharmaceutical excipient

© 2020 by the authors. Lignocellulosic biomass is widely grown in many agricultural-based countries. These are typically incinerated or discarded in open spaces, which further may cause severe health and environmental problems. Hence, the proper utilization and conversion of different parts of lignocellulosic biomasses (e.g., corn wastes derived leave, cob, stalk, and husk) into value-added materials could be a promising way of protecting both health and environments. In addition, they have high-potential for myriads applications (e.g., pharmaceuticals, cosmetics, textiles, and so on). In this context, herein, we isolated holocellulose (a mixture of alpha α, beta β, and gamma γ cellulose) from corn waste, and then it was converted into carboxymethyl cellulose (CMC). Subsequently, the prepared CMC was evaluated successfully to be used as a pharmaceutical excipient. Different characterization tools were employed for structural, morphological, and thermal properties of the extracted holocellulose and synthesized CMC. Results showed that the highest yield of CMC was obtained 187.5% along with the highest degree of substitution (DS i.e., 1.83) in a single stage (i.e., size reduction technique) with the lowest particle size of holocellulose (100 μm). This happened due to the use of a single stage instead of multiple stages. Finally, extracted CMC was successfully used as a pharmaceutical excipient with promising results compared to commercially available pharmaceutical-grade CMC

MENTAL HEALTH OUTCOMES OF ADULTS WITH COMORBIDITY AND CHRONIC DISEASES DURING THE COVID-19 PANDEMIC: A MATCHED CASE-CONTROL STUDY

Background: Individuals with certain pre-existing chronic health conditions have been identified as a high-risk group for fatalities of COVID-19. Therefore, it is likely that individuals with chronic diseases may worry during this pandemic to the detriment of their mental health. This study compares the mental health of Bangladeshi adults affected by chronic disease to a healthy, matched control group during the COVID-19 pandemic. Subjects and methods: A matched case-control analysis was performed with data collected from 395 respondents with chronic diseases and 395 controls matched for age, gender, and residence. Inclusion criteria for cases were respondents who self reported having asthma, cardiovascular disease symptoms and/or diabetes. Respondents were recruited using an online survey, which included the DASS-21 measure to assess symptoms of stress, anxiety, and depression. Chi-square test, t-test, Fisher’s exact test and a conditional logistic regression were performed to examine associations among variables. Results: The prevalence of anxiety symptoms and depression symptoms and the level of stress were significantly higher among cases (59%; 71.6%; 73.7%, respectively) than among controls (25.6%; 31.1%; 43.3%, respectively). Chi-square and t-test showed significant associations and differences between having chronic diseases and mental health outcomes. A conditional logistic regression showed that respondents with asthma, diabetes, cardiovascular disease symptoms, or any combination of these diseases had higher odds of exhibiting symptoms of stress, anxiety, and depression than healthy individuals. Conclusion: These results underscore a subpopulation vulnerable to mental health consequences during this pandemic and indicate the need for additional mental health resources to be available to those with chronic diseases

Morpho-Physiological Mechanisms of Maize for Drought Tolerance

Maize is one of the mostly consumed grains in the world. It possesses a greater potentiality of being an alternative to rice and wheat in the near future. In field condition, maize encounters abiotic stresses like salinity, drought, water logging, cold, heat, etc. Physiology and production of maize are largely affected by drought. Drought has become a prime cause of agricultural disaster because of the major occurrence records of the last few decades. It leads to immense losses in plant growth (plant height and stem), water relations (relative water content), gas exchange (photosynthesis, stomatal conductance, and transpiration rate), and nutrient levels in maize. To mitigate the effect of stress, plant retreats by using multiple morphological, molecular, and physiological mechanisms. Maize alters its physiological processes like photosynthesis, oxidoreductase activities, carbohydrate metabolism, nutrient metabolism, and other drought-responsive pathways in response to drought. Synthesis of some chemicals like proline, abscisic acid (ABA), different phenolic compounds, etc. helps to fight against stress. Inoculation of plant growth-promoting rhizobacteria (PGPR) can result to the gene expression involved in the biosynthesis of abscisic acid which also helps to resist drought. Moreover, adaptation to drought and heat stress is positively influenced by the activity of chaperone proteins and proteases, protein that responds to ethylene and ripening. Some modifications generated by clustered regularly interspaced short palindromic repeat (CRISPR)-Cas9 are able to improve maize yield in drought. Forward and reverse genetics and functional and comparative genomics are being implemented now to overcome stress conditions like drought. Maize response to drought is a multifarious physiological and biochemical process. Applying data synthesis approach, this study aims toward better demonstration of its consequences to provide critical information on maize tolerance along with minimizing yield loss

Malarial Retinopathy in Bangladeshi Adults

To establish if assessment of malarial retinopathy in adult malaria using ophthalmoscopy by non-ophthalmologists has clinical and prognostic significance, 210 Bangladeshi adults were assessed by both direct and indirect ophthalmoscopy; 20 of 20 healthy subjects and 20 of 20 patients with vivax malaria showed no retinal changes, whereas in patients with falciparum malaria, indirect ophthalmoscopy revealed malarial retinopathy (predominantly retinal hemorrhages) in 18 of 21 (86%) fatal, 31 of 75 (41%) cerebral, 16 of 64 (25%) non-cerebral but severe, and 1 of 31 (3%) uncomplicated cases. Direct ophthalmoscopy missed retinopathy in one of these cases and found fewer retinal hemorrhages (mean difference = 3.09; 95% confidence interval = 1.50–4.68; P < 0.0001). Severity of retinopathy increased with severity of disease (P for trend < 0.0001), and renal failure, acidosis, and moderate/severe retinopathy were independent predictors of mortality by both ophthalmoscopic techniques. Direct ophthalmoscopy by non-ophthalmologists is an important clinical tool to aid diagnosis and prognosis in adults with severe malaria, and indirect ophthalmoscopy by non-ophthalmologists, although more sensitive, provides minimal additional prognostic information

Timing of Enteral Feeding in Cerebral Malaria in Resource-Poor Settings: A Randomized Trial

BACKGROUND: Early start of enteral feeding is an established treatment strategy in intubated patients in intensive care since it reduces invasive bacterial infections and length of hospital stay. There is equipoise whether early enteral feeding is also beneficial in non-intubated patients with cerebral malaria in resource poor settings. We hypothesized that the risk of aspiration pneumonia might outweigh the potential benefits of earlier recovery and prevention of hypoglycaemia. METHOD AND FINDINGS: A randomized trial of early (day of admission) versus late (after 60 hours in adults or 36 hours in children) start of enteral feeding was undertaken in patients with cerebral malaria in Chittagong, Bangladesh from May 2008 to August 2009. The primary outcome measures were incidence of aspiration pneumonia, hypoglycaemia and coma recovery time. The trial was terminated after inclusion of 56 patients because of a high incidence of aspiration pneumonia in the early feeding group (9/27 (33%)), compared to the late feeding group (0/29 (0%)), p = 0.001). One patient in the late feeding group, and none in the early group, had hypoglycaemia during admission. There was no significant difference in overall mortality (9/27 (33%) vs 6/29 (21%), p = 0.370), but mortality was 5/9 (56%) in patients with aspiration pneumonia. CONCLUSIONS: In conclusion, early start of enteral feeding is detrimental in non-intubated patients with cerebral malaria in many resource-poor settings. Evidence gathered in resource rich settings is not necessarily transferable to resource-poor settings. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN57488577