The outcome of loop electrosurgical excision procedure following treatment of cervical intra-epithelial neoplasia 2 and 3

Background: In Bangladesh, loop electrosurgical excision procedure (LEEP) is an ongoing program of government health service for the management of cervical intra-epithelial neoplasia (CIN) 2 and 3. The aim of this study was to evaluate the outcome of loop electrosurgical excision procedure following treatment of cervical intra-epithelial neoplasia 2 and 3. Methods: This descriptive cross-sectional study was conducted in outpatient department (OPD), gynaecology and obstetrics department, Rangpur Medical College Hospital, Rangpur, Bangladesh during the period from July 2011 to June 2012. In total 75 patients, underwent LEEP following treatment of CIN 2 and 3 were selected for this study as study subjects. Data analysis was done by using statistical package for social science (SPSS) 16 version. Results: In this study, majority of the participants were from 30-39 years’ age group which was 57%. Besides this 23%, 19% and 1% patients were from <30, 40-49 and ≥50 age groups respectively. The mean parity of the patients was 3.68 with standard deviation of ±1.31 and range was 1 to 7. In analyzing the parity of the participants, we observed that, in 47% and 24% patients the party were 2 and 3 respectively which were noticeable. Besides these in 11%, 8%, 7%, 1% and 3% cases the parity were found as 1, 4, 5, 6 and 7 respectively. In analyzing the histopathology among patients, we found, 76% cases were with CIN-1 whereas the rest 24% cases were with CIN-2. Conclusions: Cervical cancer is the most common malignancy and a major cause of cancer death among Bangladeshi women. This may be due to lack of awareness, scarce of screening facility, poverty and illiteracy. The LEEP procedure has many advantages including high success rate, low cost and ease of use

The stress factors and pattern of psychiatric disorders among patients with deliberate self-harm: a study in a tertiary care hospital, Rangpur, Bangladesh

Background: Deliberate self-harm (DSH) is a complex behavior of maladaptive response to acute and chronic stress, and likely to be suffering from mental health problems as well as co-morbid general medical conditions, including several non-suicidal intentions to suicide. DSH is previously included in suicide. Sir Thomas Browne first used the word ‘suicide’ in 1642 in his religion Medici. The word suicide originated from SUI (of oneself) and CAEDES (murder). According to WHO ‘suicide’ refers to the act of killing oneself intentionally, performed by the person with full knowledge or expectation of the fatal outcome. This study aimed to analyze the stress factors and pattern of psychiatric disorders among patients with DSH. Methods: This descriptive cross-sectional study was conducted at the department of medicine; emergency and OPD, Rangpur medical college, Rangpur, Bangladesh. Study conducted for 1 year; July 2008-June 2009. A total of 116 DSH cases included in study as per inclusion criteria. Convenience sampling technique was undertaken in this study. Result: The majority of patients are in the age group of 20-39 years, with 70% in a psychiatric disorder, and in the 40-59 years age group 7.778% have a psychiatric disorder. Age has a significant relationship with DSH (p<0.001). The 90 patients were suffering from psychiatric disorders among them 61 (67.778%) were suffering from depressive episodes, 12 (13.333%) were suffering from a personality disorder, 8 (8.889%) were suffering from mental and behavioral disorders due to psychoactive substance abuse, 7 (7.778%) were suffering from schizophrenia, 1 (01.111%) were suffering from adjustment disorder, 1 (1.111%) suffering from bipolar disorder. Conclusions: Out of 116 responders 90 (77.586%) were suffering from a psychiatric disorder. Among the patients with psychiatric disorders, 61 (67.778%) patients were found to be suffering from a depressive episode, which was 52.568% of total DSH cases and is an almost treatable disorder.

Quorum Regulated Resistance of Vibrio cholerae against Environmental Bacteriophages

Predation by bacteriophages can significantly influence the population structure of bacterial communities. Vibrio cholerae the causative agent of cholera epidemics interacts with numerous phages in the aquatic ecosystem, and in the intestine of cholera patients. Seasonal epidemics of cholera reportedly collapse due to predation of the pathogen by phages. However, it is not clear how sufficient number of the bacteria survive to seed the environment in the subsequent epidemic season. We found that bacterial cell density-dependent gene expression termed “quorum sensing” which is regulated by signal molecules called autoinducers (AIs) can protect V. cholerae against predatory phages. V. cholerae mutant strains carrying inactivated AI synthase genes were significantly more susceptible to multiple phages compared to the parent bacteria. Likewise when mixed cultures of phage and bacteria were supplemented with exogenous autoinducers CAI-1 or AI-2 produced by recombinant strains carrying cloned AI synthase genes, increased survival of V. cholerae and a decrease in phage titer was observed. Mutational analyses suggested that the observed effects of autoinducers are mediated in part through the quorum sensing-dependent production of haemaglutinin protease, and partly through downregulation of phage receptors. These results have implication in developing strategies for phage mediated control of cholera

Obesity phenotypes and their adipocyte dysfunction among the attendants at outpatient department

The present study was aimed to find out the frequency of obesity phenotypes and to correlate adipocyte dysfunction with different obesity phenotypes. A total of 1,507 apparently healthy adults attending the outpatient department were grouped into three based on body mass index which were then further categorized into six groups according to metabolically unhealthy or healthy phenotypes by the presence or absence of metabolic syndrome. Of them, metabolically obese normal weight, overweight, healthy obese and unhealthy obese groups were included as obesity phenotypes. Then by purposive sampling, leptin and adiponectin concentration of 184 subjects with different phenotypes were measured to find out the adipocyte dysfunction. Metabolically obese overweight followed by metabolically unhealthy obese were more prevalent i,e.,  24.9% and 19.5%. All obesity phenotypes except metabolically obese normal weight were significantly documented with adipocyte dysfunction (p<0.05)

Serum Lipids and Diabetic Retinopathy in Newly Diagnosed Type 2 Diabetic Subjects

Background: Diabetic retinopathy is the commonest and usually the first observable vascular complication of diabetes mellitus. Along with hyperglycaemia, dyslipidaemia is a contributing factor for the occurrence of diabetic retinopathy. It is postulated that dyslipidaemia results in formation of hard exudate by increasing blood viscosity and altering the fibrinolytic system. A case control study was carried out in the department of Biochemistry, Bangabandhu Sheikh Mujib Medical University, Dhaka during the period of January 2006 to December 2007 to evaluate the serum lipid profile in newly diagnosed type 2 diabetic subjects with diabetic retinopathy. Materials and Methods: Total 85 newly diagnosed type 2 diabetic subjects were included in this study, 40 were cases having retinopathy and 45 were age and sex matched controls without retinopathy. Serum triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were compared between cases and controls. Unpaired t-test and chi-square test were done between groups as tests of significance. Results: All the parameters of lipid profile showed dyslipidaemic trend both in cases and controls. In the cases TG was significantly higher and HDL-C was significantly lower than that of controls (p < 0.05) whereas no significant difference was found between cases and controls with respect to serum TC and LDL-C. Conclusion: It can be concluded that high TG and low HDL-C are associated with diabetic retinopathy in newly diagnosed type 2 diabetes

Toward Smaller Aqueous-Phase Plasmonic Gold Nanoparticles: High-Stability Thiolate-Protected ~ 4.5 Nm Cores

Most applications of aqueous plasmonic gold nanoparticles benefit from control of the core size and shape, control of the nature of the ligand shell, and a simple and widely applicable preparation method. Surface functionalization of such nanoparticles is readily achievable but is restricted to water-soluble ligands. Here we have obtained highly monodisperse and stable smaller aqueous gold nanoparticles (core diameter ~ 4.5-nm), prepared from citrate-tannate precursors via ligand exchange with each of three distinct thiolates: 11-mercaptoundecanoic acid, a-R-lipoic acid, and para-mercaptobenzoic acid. These are characterized by UV-Vis spectroscopy for plasmonic properties; FTIR spectroscopy for ligand exchange confirmation; X-ray diffractometry for structural analysis; and high-resolution transmission electron microscopy for structure and size determination. Chemical reduction induces a blueshift, maximally +0.02-eV, in the localized surface-plasmon resonances band; this is interpreted as an electronic (-) charging of the MPC gold core, corresponding to a -0.5-V change in electrochemical potential.</p

Vibrio cholerae strains with inactivated cqsS gene overproduce autoinducer-2 which enhances resuscitation of dormant environmental V. cholerae.

BACKGROUND:Toxigenic Vibrio cholerae resides in aquatic reservoirs of cholera-endemic areas mostly in a dormant form known as conditionally viable environmental cells (CVEC) in which the bacteria remain embedded in an exopolysaccharide matrix, and fail to grow in routine bacteriological culture. The CVEC can be resuscitated by supplementing culture media with either of two autoinducers CAI-1 and AI-2, which are signal molecules controlling quorum sensing, a regulatory network of bacterial gene expression dependent on cell density. This study investigated possible existence of variant strains that overproduce AIs, sufficient to resuscitate CVEC in environmental waters. METHODS:Environmental V. cholerae isolates and Tn insertion mutants of a V. cholerae strain C6706 were screened for production of AIs using bioluminescent reporter strains. Relevant mutations in environmental strains which overproduced AI-2 were characterized by nucleotide sequencing and genetic complementation studies. Effect of AIs produced in culture supernatants of relevant strains on reactivation of CVEC in water was determined by resuscitation assays. RESULTS:Two of 54 environmental V. cholerae isolates were found to overproduce AI-2. Screening of a Tn-insertion library of V. cholerae strain C6706, identified a mutant which overproduced AI-2, and carried Tn insertion in the cqsS gene. Nucleotide sequencing also revealed mutations inactivating the cqsS gene in environmental isolates which overproduced AI-2, and this property was reversed when complemented with a wild type cqsS gene. Culture of river water samples supplemented with spent medium of these mutants resuscitated dormant V. cholerae cells in water. SIGNIFICANCE:V. cholerae strains with inactivated cqsS gene may offer a convenient source of AI-2 in enhanced assays for monitoring bacteriological quality of water. The results also suggest a potential role of naturally occurring cqsS mutants in the environmental biology of V. cholerae. Furthermore, similar phenomenon may have relevance in the ecology of other waterborne bacterial pathogens beyond V. cholerae