Acute Ischemic Stroke- A presenting feature of SARS-CoV-2 infection

The ongoing pandemic caused by coronavirus disease (COVID-19) is now a global concern. Although SARS-CoV-2 primarily involves lung, there are emerging data on involvement of heart, brain, kidney, gastrointestinal tract, liver and others. Amongst neurological manifestations, acute stroke, encephalitis and GBS are reported. Here we describe two RT-PCR confirmed SARS-CoV-2 infected patients presented with acute ischemic stroke. The possible background mechanisms are arterial thrombosis due to hypercoagulability, direct and immune-mediated neuronal damage, viral vasculopathy, cardio-embolism etc. BSMMU J 2021; 14 (COVID -19 Supplement): 60-6

Salbutamol in acute organophosphorus insecticide poisoning - a pilotdose-response phase II study

Treatment of acute organophosphorus (OP) insecticide poisoning is difficult, with many patients dying despite best care. Pre-clinical studies have shown benefit from salbutamol, possibly due speeding alveolar fluid clearance or reducing bronchoconstriction. In this small pilot dose-response study, we aimed to explore whether addition of nebulized salbutamol to standard care might improve resuscitation.We performed a single-blind phase II study comparing the effect of two different doses of nebulized salbutamol versus saline placebo, in addition to standard treatment. Primary outcome was oxygen saturations over the first 60 min of resuscitation; secondary outcomes included heart rate, incidence of dysrhythmias, time to 'atropinization', atropine dose required, and mortality.Seventy-five patients were randomized to receive 5 mg (Salb5, n = 25) or 2.5mg (Salb2.5, n = 25) of salbutamol, or saline placebo (NoSalb, n = 25), by nebulizer. Oxygen saturations did not differ between groups over the first 60 min of resuscitation (median AUC NoSalb: 1376 [95% CI 1282 to 1470], Salb2.5: 1395 [1305 to 1486], Salb5: 1233 [1100 to 1367]; p = .9898). Heart rate was also similar across the three arms. Median time to full atropinization, and atropine dose required, were the same for all three arms (NoSalb 15.0 [10-16] min and 12.6 [8.0-13.4] mg, Salb2.5 15.0 [10-16] min and 12.6 [9.3-16.8] mg, and Salb5 15.0 [10-20] min and 12.6 [10.7-20.6] mg; p = .4805 and p = .1871, respectively). Three (12%) patients died in the Salb2.5 and Salb5 groups and two (8%) in the NoSalb group.This pilot study, within the limitations of its small size and variation between patients, found no apparent evidence that administration of nebulized salbutamol improved resuscitation of patients with acute OP insecticide self-poisoning. The data obtained provides a basis to design further studies to ultimately test the role of salbutamol in OP insecticide poisoning

Heavy metals accumulation in some important fish species cultured in commercial fish farm of Natore, Bangladesh and possible health risk evaluation

Heavy metal contamination in aquatic environment is a serious concern throughout the world. Metal contamination are responsible for the accumulation of metals within the fish body. And, consumption of these contaminated fish possess serious threat to the associated consumers. In this current study, five commonly cultured freshwater fishes (rui, Labeo rohita; mrigal, Cirrhinus mrigala; silver carp, Hypophthalmicthys molitrix; bata, Labeo bata, and sarpunti, Puntius sarana) were collected from a commercial fish farm of Natore district, Bangladesh to analyze metals levels in edible portion (flesh), and to assess the associated human health risk. Several heavy metals such as zinc (Zn); cadmium (Cd); chromium (Cr); arsenic (As); lead (Pb); and nickel (Ni) were analyzed by a flame atomic absorption spectrophotometer. Besides, the target hazard quotient (THQ), hazard index (HI) and lifetime cancer risk (TR) were also estimated for assessing the associated human health risk. In this study, concentrations of Zn, Cd, Cr, As, Pb and Ni in different fish species were found 6.36 ± 1.48 to 13.31 ± 1.33; 0.017 ± 0.01 to 0.049 ± 0.02; 0.654 ± 0.04; 0.015 ± 0.01 to 0.033 ± 0.01; 0.534 ± 0.11 and 0.08 ± 0.05, respectively. All the analyzed values were within the recommended level except Cr in C. mrigala. The THQ, HI and TR values of all the analyzed metals in the fishes indicated that no associated cancer risk resulting from the consumption of those fishes. Therefore, the current study revealed that fishes of the target area might be free from associated metals contamination and hence, might be safe for human consumption

First record of Uperodon globulosus (Günther, 1864) (Anura, Microhylidae) in Rajshahi Division, Bangladesh

Uperodon globulosus (Günther, 1864) has so far been recorded from 6 localities in Bangladesh over the past 3 decades. In June 2017, we found an adult female in a courtyard of a house in Jonail village (Natore district, Rajshahi division, Bangladesh), which is approximately 102 km southwest of the previous nearest previously known occurrence of this species

HYPOTHYROIDISM AND NEPHROTIC SYNDROME- A RARE ASSOCIATION

Hypothyroidism may coexist with different renal pathologies. 1 Several cases of glomerular diseases have been associated with thyroid diseases of which the most frequent lesion described is membranou

Activation of Human Salivary Aldehyde Dehydrogenase by Sulforaphane: Mechanism and Significance.

Cruciferous vegetables contain the bio-active compound sulforaphane (SF) which has been reported to protect individuals against various diseases by a number of mechanisms, including activation of the phase II detoxification enzymes. In this study, we show that the extracts of five cruciferous vegetables that we commonly consume and SF activate human salivary aldehyde dehydrogenase (hsALDH), which is a very important detoxifying enzyme in the mouth. Maximum activation was observed at 1 μg/ml of cabbage extract with 2.6 fold increase in the activity. There was a ~1.9 fold increase in the activity of hsALDH at SF concentration of ≥ 100 nM. The concentration of SF at half the maximum response (EC50 value) was determined to be 52 ± 2 nM. There was an increase in the Vmax and a decrease in the Km of the enzyme in the presence of SF. Hence, SF interacts with the enzyme and increases its affinity for the substrate. UV absorbance, fluorescence and CD studies revealed that SF binds to hsALDH and does not disrupt its native structure. SF binds with the enzyme with a binding constant of 1.23 x 107 M-1. There is one binding site on hsALDH for SF, and the thermodynamic parameters indicate the formation of a spontaneous strong complex between the two. Molecular docking analysis depicted that SF fits into the active site of ALDH3A1, and facilitates the catalytic mechanism of the enzyme. SF being an antioxidant, is very likely to protect the catalytic Cys 243 residue from oxidation, which leads to the increase in the catalytic efficiency and hence the activation of the enzyme. Further, hsALDH which is virtually inactive towards acetaldehyde exhibited significant activity towards it in the presence of SF. It is therefore very likely that consumption of large quantities of cruciferous vegetables or SF supplements, through their activating effect on hsALDH can protect individuals who are alcohol intolerant against acetaldehyde toxicity and also lower the risk of oral cancer development

SUBDIAPHRAMATIC PRESENTATION OF HODGKIN’S LYMPHOMA WITH PERIPHERAL NEUROPATHY

A 27 years old, unmarried male day labour, hailing from Jhalkathi presented to us with the complains of anorexia, weight loss and gradual weakness of all limbs for 6 months. On examination, he had features of peripheral neuropathy, but other systemic examinations were unremarkable. He did not have any significant lymphadenopathy or hepatosplenomegaly.He was diagnosed as a case of Hodgkin’s Lymphoma, lymphocyte predominance, after diagnostic laparotomy followed by excisional biopsy from intraabdominal lymph node.Subdiaphramatic Hodgkin’s lymphoma is rarely occurs and may present in several ways. Peripheral neuropathy is one of these. We treated him with Doxorubicin, Bleomycin, Vinblastin and Dacarbazine with successful outcome. The lymphoma arise as a malignant proliferation of lymphoid system and hence occur at any site where lymphoid tissue is present. Hodgkin’s lymphoma is a rare disease involving primarily lymph nodes.

KNEE JOINT TUBERCULOSIS PRESENTING AS IMMUNE THROMBOCYTOPENIA

Tuberculosis (TB) is a major public health problem of increasing proportions in Bangladesh for last several decades. A total of 350,641 cases were reported i