A perfect storm : polycystic ovary syndrome masking underlying yype 1 Von Willebrand disease

Von Willebrand Disease (vWD) is the most common inherited bleeding diathesis worldwide and results in defects in von Willebrand Factor (vWF), inducing a hypocoagulable state. Polycystic Ovary Syndrome (PCOS) is characterized by chronic inflammation and hyperestrogenism, both of which induce acute phase reactions and increase serum levels of vWF and Factor VIII, yielding a prothrombotic state. These laboratory elevations may obscure the diagnosis of underlying vWD in patients with both conditions. We report a case of a 23 year-old female with PCOS and menorrhagia who presented prior to a surgical procedure for evaluation of bleeding risk

Regeneration potential of seedling explants of chilli (Capsicum annuum)

A study was conducted with hypocotyl, cotyledon and shoot tip of chilli as explants for regeneration on MS medium supplemented with different concentrations and combinations of auxins and cytokinins. Regeneration potential was determined by two ways. One is regeneration of shoot via callus formation from hypocotyls and cotyledon explants; another was direct shoot regeneration from shoot tip explant. The highest callus was induced from hypocotyl in a combination of BAP (5.0 mgL-1) with NAA (0.1 mgL-1) and cotyledon in a combination of BAP (5.0 mgL-1) with IAA ((1.0 mgL-1). The callus induction as well as shoot initiation was higher in hypocotyls than cotyledon. Shoot tips regenerated into plantlets directly with sporadic small callus at the base. Shoot elongation was accelerated by using additional supplementation of GA3 and AgNO3. Regenerated shoots rooted best on the MS medium supplemented with 0.1 mg L-1 NAA + 0.05 mg L-1 IBA

Role of bronchoalveolar lavage in the diagnosis of lung cancer

Background: Early diagnosis of lung cancer plays a vital role in reducing the lung cancer death rate. Different modalities can be applied e.g. radiology, bronchoscopy, bronchoalveolar lavage (BAL), and fine needle aspiration cytology. Cytological diagnostic techniques are safer, economical, and provide quick results. The aim of the study was to find out diagnostic yields of bronchoalveolar lavage in diagnosing lung cancer, and to determine the sensitivity, and specificity of BAL fluid cytology considering the bronchial biopsy as the gold standard.Methods: This cross-sectional study was carried out in the Department of Respiratory Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka during the period from November 2018 to March 2020 with a total of 38 participants.Results: 33 (86.84%) patients were male, and 5 (13.16%) were female; the mean age was 58.29±13.11 years. In clinical presentations, cough was present in all 100% of the patients, and some more frequent presentations were shortness of breath in 26 (68.4%), hemoptysis in 24 (63.15%), and chest pain in 21 (55.26%). Majority of the patients (78.95%) were smokers. Considering histopathological findings, maximum patients had squamous cell carcinoma 13 (38.23%), then adenocarcinoma 11 (32.35%), small cell carcinoma 5 (14.70%), large cell carcinoma 3 (8.82%), and poorly differentiated non-small cell carcinoma 2 (5.88%). The sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of BAL were 70.59%, 100%, 100%, 28.57%, and 73.68% respectively.Conclusions: BAL fluid cytology is a useful tool for the diagnosis of lung cancer. It has good sensitivity, and specificity, and shows nearly identical information as biopsy

Association of serum alpha-1 antitrypsin level with the severity of COPD

Background: Alpha-1 antitrypsin deficiency (AATD) is a hereditary disorder linked to early onset COPD, notably the emphysema variety, but often goes undetected. Low serum AAT levels may impact lung function and correlate with COPD severity. The aim of the study was to detect possible associations of serum AAT level with the severity of COPD patients on the basis of post bronchodilator FEV1 in Bangabandhu Sheikh Mujib Medical University (BSMMU). Methods: A cross-sectional study was conducted at the Department of Respiratory Medicine, BSMMU, Dhaka, from October 2022 to September 2023. Adult patients (≥18 years) of both genders diagnosed with COPD based on spirometry were included. COPD was defined per GOLD guidelines, with a post-bronchodilator FEV1/FVC ratio <70%. Severity was categorized based on post-bronchodilator FEV1% predicted. Association between serum AAT level and COPD severity was analyzed using SPSS version 26, with significance set at p <0.05. Results: The study involved 80 COPD patients, with 1.25% showing low serum AAT levels and 98.75% normal. No significant differences in age, sex, or smoking status were observed among severity groups. Mean serum AAT levels varied across severity groups but were not statistically significant (p=0.377). Smoking was prevalent (66.3%), with common comorbidities like hypertension (26.3%), IHD (16.3%), and diabetes mellitus (15.0%). Shortness of breath (95.0%) and cough (92.5%) were common symptoms, with most patients having moderate disease severity (42.5%). Conclusions: The study indicates a weak association between serum AAT levels and COPD severity, with only 1.25% of 80 patients exhibiting low AAT levels

Rickettsial illnesses as important causes of febrile illness in Chittagong, Bangladesh

We conducted a yearlong prospective study of febrile patients admitted to a tertiary referral hospital in Chittagong, Bangladesh, to assess the proportion of patients with rickettsial illnesses and identify the causative pathogens, strain genotypes, and associated seasonality patterns. We diagnosed scrub typhus in 16.8% (70/416) and murine typhus in 5.8% (24/416) of patients; 2 patients had infections attributable to undifferentiated Rickettsia spp. and 2 had DNA sequence-confirmed R. felis infection. Orientia tsutsugamushi genotypes included Karp, Gilliam, Kato, and TA763-like strains, with a prominence of Karp-like strains. Scrub typhus admissions peaked in a biphasic pattern before and after the rainy season, whereas murine typhus more frequently occurred before the rainy season. Death occurred in 4% (18/416) of cases; case-fatality rates were 4% each for scrub typhus (3/70) and murine typhus (1/28). Overall, 23.1% (96/416) of patients had evidence of treatable rickettsial illnesses, providing important evidence toward optimizing empirical treatment strategies

Kineticism in housing

Typescript (photocopy).Digitized by Kansas Correctional Industrie

REVIEW ARTICLES Obstructive sleep apnea and cardiovascular effects-a review

Obstructive sleep apnea (OSA) is the most common form of sleep-disordered breathing, affecting 5–15 % of the population. It is characterized by intermittent episodes of partial or complete obstruction of the upper airway during sleep that disrupts normal ventilation and sleep architecture, and is typically associated with excessive daytime sleepiness, snoring, and witnessed apneas. Patients with obstructive sleep apnea present risk to the general public safety by causing 8-fold increase in vehicle accidents, and they may themselves also suffer from the physiologic consequences of OSA; these include hypertension, coronary artery disease, stroke, congestive heart failure, pulmonary hypertension, and cardiac arrhythmias. Of these possible cardiovascular consequences, the association between OSA and hypertension has been found to be the most convincing. Although the exact mechanism has not been understood, there is some evidence that OSA is associated with frequent apneas causing mechanical effects on intrathoracic pressure, cardiac function, and intermittent hypoxemia, which may in turn cause endothelial dysfunction and increase in sympathetic drive. Therapy with continuous positive airway pressure has been demonstrated to improve cardiopulmonary hemodynamics in patients with OSA and may reverse the endothelial cell dysfunction. Limited availability of diagnostic measures and unawareness of physicians, many patients with OSA remain undiagnosed. Awareness and timely initiation of an effective treatment may prevent potential deleterious cardiovascular effects of OSA. Key words Obstructive Sleep apnea, Hypertension, Atherosclerosis, Continuous positive airway pressure

Nocinv : development of a smartphone application for predicting chemotherapy-induced nausea and vomiting using apple researchkit

"Using risk calculation algorithms for clinical decision making at the point-of-care can lead to incorrect results and hours of time for a complete panel of patients. Smartphones have become very popular among physicians over the last decade for accessing healthcare information at the point-of-care. The advent of Apple Research Kit has opened tremendous opportunities to capture patient- related data and deliver patient-specific clinical decision support information through the smartphones. The total number of mobile health apps having Clinical Decision Support functionalities have been on the rise in recent years."--Introduction