Nutritional status of children in India: household socio-economic condition as the contextual determinant

<p>Abstract</p> <p>Background</p> <p>Despite recent achievement in economic progress in India, the fruit of development has failed to secure a better nutritional status among all children of the country. Growing evidence suggest there exists a socio-economic gradient of childhood malnutrition in India. The present paper is an attempt to measure the extent of socio-economic inequality in chronic childhood malnutrition across major states of India and to realize the role of household socio-economic status (SES) as the contextual determinant of nutritional status of children.</p> <p>Methods</p> <p>Using National Family Health Survey-3 data, an attempt is made to estimate socio-economic inequality in childhood stunting at the state level through Concentration Index (CI). Multi-level models; random-coefficient and random-slope are employed to study the impact of SES on long-term nutritional status among children, keeping in view the hierarchical nature of data.</p> <p>Main findings</p> <p>Across the states, a disproportionate burden of stunting is observed among the children from poor SES, more so in urban areas. The state having lower prevalence of chronic childhood malnutrition shows much higher burden among the poor. Though a negative correlation (r = -0.603, p < .001) is established between Net State Domestic Product (NSDP) and CI values for stunting; the development indicator is not always linearly correlated with intra-state inequality in malnutrition prevalence. Results from multi-level models however show children from highest SES quintile posses 50 percent better nutritional status than those from the poorest quintile.</p> <p>Conclusion</p> <p>In spite of the declining trend of chronic childhood malnutrition in India, the concerns remain for its disproportionate burden on the poor. The socio-economic gradient of long-term nutritional status among children needs special focus, more so in the states where chronic malnutrition among children apparently demonstrates a lower prevalence. The paper calls for state specific policies which are designed and implemented on a priority basis, keeping in view the nature of inequality in childhood malnutrition in the country and its differential characteristics across the states.</p

Application of toluidine blue stain and neuron specific enolase immunohistochemical stain in the diagnosis of hirschsprung disease

Hirschsprung disease is one of the most common and problematic infancy and childhood maladies. Early and accurate diagnosis is a fundamental step in proper management and prevention of complications. The most reliable method for diagnosis is the histopathological analysis of colorectal biopsies and the typical finding of Hirschsprung disease is the absence of ganglion cells. Toluidine blue stain can act as a double check along with conventional H&amp;E stain for ganglion cell detection. Neuron-specific enolase is an immune-histochemical marker that can also aid in better identifying ganglion cells, especially for small and immature ones. This study aimed to evaluate Toluidine blue stain and Neuron specific enolase immunostain along with conventional H&amp;E stain as a panel for the diagnosis of Hirschsprung disease. This cross-sectional study was conducted from September 2019 to August 2021, involving 55 clinically suspected Hirschsprung disease cases. Paraffin blocks of colorectal biopsy samples were collected from the Department of Pathology, BSMMU. Hematoxylin &amp; Eosin, Toluidine blue stain, and Neuron specific enolase immunohistochemical stain for Hirschsprung disease detection were performed on the sections from the paraffin blocks. Then the sections were examined and an evaluation of the stains was done. Statistical analysis was performed on the tabulated data by chi-square test. Among 55 cases, conventional H&amp;E stain detected ganglion cells in 31 cases, that is 56.4%. Later, Toluidine blue stain and Neuron specific enolase immu- nohistochemical stain detected ganglion cells in 35 cases, that is 63.6%. So, these two addition- al stains were able to detect ganglion cells in four more cases compared to conventional H&amp;E stain. In conclusion, conventional H&amp;E stain, Toluidine blue stain, and NSE immunohisto- chemical stain can improve the diagnostic accuracy of Hirschsprung disease. BSMMU J 2022; 15(2): 102-10

Degree of fibrosis and its association with angiogenesis in the myelofibrotic bone marrow

Background: Primary and secondary myelofibrosis has become a global burden due to its increased mortality and morbidity. Angiogenesis is a significant driving force in the development of fibrogenesis in the bone marrow, which leads to myelofibrosis. The microvascular density (MVD) with immunomarker CD34 can be used to assess the degree of angiogenesis. The objective of this study was to examine the association between degree of myelofibrosis and angiogenesis in hematological malignancies. Methods: Forty-six trephine biopsy specimens of various hematological malignancies with myelofibrosis were studied at the Department of Pathology of Bangabandhu Sheikh Mujib Medical University. Extent of myelofibrosis in each case was assessed by examining the reticulin and Masson’s trichrome stained sections using a semiquantitative grading system of bone marrow fibrosis (MF) within a scale of MF-0 to MF-3. Angiogenesis was measured by counting MVD in the ‘hotspots’ after immunostaining with CD34 antibody. Results: The trephine biopsy cases were grouped into early fibrotic (MF-1) and advanced fibrotic (MF-2,3) consisting of 16 (34.8%) and 30 (65.2%) patients, respectively. Angiogenesis was estimated as mean MVD count which revealed 16.7 ± 5.4 and 32.0 ± 11.5 in these groups, respectively.  Significant difference of mean MVD values     (P&lt;0.001) between the early and advanced fibrotic groups revealed the association of angiogenesis and degree of myelofibrosis. Conclusion: MVD may be used to measure angiogenesis in myelofibrotic marrow along with other clinical and laboratory indices as a marker of disease activity in hematological malignancies, thus aiding disease prognosis.

Association of Ki-67 expression in radical cystectomy specimens of infiltrating urothelial carcinoma with histopathological parameters

Urothelial carcinoma is the most common neoplasm of urinary bladder. Antigen Ki-67 is a nuclear protein that is necessary for cellular proliferation. The aim of this study was to determine the association of expression of Ki-67 with histopathological parameters in radical cystectomy specimens of histologically diagnosed cases of infiltrating urothelial carcinoma. This is a cross-sectional study conducted among 36 cases of infiltrating urothelial carcinoma collected from Department of Pathology, Bangabandhu Sheikh Mujib Medical University. Histopathological parameters i.e. morphologic variants, stage (pT), lympho-vascular invasion, perineural invasion and lymph node metastasis were assessed. Ki-67 immunohistochemistry were performed. Mean ±SD age of the patients was 58.9±13.8 years. Among the morphological variants, 64% cases were microscopically arranged in papillary pattern. Eighteen (50%) patients underwent surgical intervention at stage pT2. Lympho-vascular invasion, perineural invasion and lymph node metastasis were identified in 12 (33.3%), 9 (25%) and 13 (48.1%) of the cases, respectively. Among the morphological parameters, Ki-67 shows association with pathological stages and lymph node metastasis. The use of Ki-67 immunomarker along with grading and staging may provide significant prognostic information in urothelial carcinoma of the urinary bladder. BSMMU J 2022; 15(3): 186-19

Application of toluidine blue stain and neuron specific enolase immunohistochemical stain in the diagnosis of hirschsprung disease

Hirschsprung disease is one of the most common and problematic infancy and childhood maladies. Early and accurate diagnosis is a fundamental step in proper management and prevention of complications. The most reliable method for diagnosis is the histopathological analysis of colorectal biopsies and the typical finding of Hirschsprung disease is the absence of ganglion cells. Toluidine blue stain can act as a double check along with conventional H&E stain for ganglion cell detection. Neuron-specific enolase is an immune-histochemical marker that can also aid in better identifying ganglion cells, especially for small and immature ones. This study aimed to evaluate Toluidine blue stain and Neuron specific enolase immunostain along with conventional H&E stain as a panel for the diagnosis of Hirschsprung disease. This cross-sectional study was conducted from September 2019 to August 2021, involving 55 clinically suspected Hirschsprung disease cases. Paraffin blocks of colorectal biopsy samples were collected from the Department of Pathology, BSMMU. Hematoxylin & Eosin, Toluidine blue stain, and Neuron specific enolase immunohistochemical stain for Hirschsprung disease detection were performed on the sections from the paraffin blocks. Then the sections were examined and an evaluation of the stains was done. Statistical analysis was performed on the tabulated data by chi-square test. Among 55 cases, conventional H&E stain detected ganglion cells in 31 cases, that is 56.4%. Later, Toluidine blue stain and Neuron specific enolase immu- nohistochemical stain detected ganglion cells in 35 cases, that is 63.6%. So, these two addition- al stains were able to detect ganglion cells in four more cases compared to conventional H&E stain. In conclusion, conventional H&E stain, Toluidine blue stain, and NSE immunohisto- chemical stain can improve the diagnostic accuracy of Hirschsprung disease. BSMMU J 2022; 15(2): 102-10

Degree of fibrosis and its association with angiogenesis in the myelofibrotic bone marrow

Background: Primary and secondary myelofibrosis has become a global burden due to its increased mortality and morbidity. Angiogenesis is a significant driving force in the development of fibrogenesis in the bone marrow, which leads to myelofibrosis. The microvascular density (MVD) with immunomarker CD34 can be used to assess the degree of angiogenesis. The objective of this study was to examine the association between degree of myelofibrosis and angiogenesis in hematological malignancies. Methods: Forty-six trephine biopsy specimens of various hematological malignancies with myelofibrosis were studied at the Department of Pathology of Bangabandhu Sheikh Mujib Medical University. Extent of myelofibrosis in each case was assessed by examining the reticulin and Masson’s trichrome stained sections using a semiquantitative grading system of bone marrow fibrosis (MF) within a scale of MF-0 to MF-3. Angiogenesis was measured by counting MVD in the ‘hotspots’ after immunostaining with CD34 antibody. Results: The trephine biopsy cases were grouped into early fibrotic (MF-1) and advanced fibrotic (MF-2,3) consisting of 16 (34.8%) and 30 (65.2%) patients, respectively. Angiogenesis was estimated as mean MVD count which revealed 16.7 ± 5.4 and 32.0 ± 11.5 in these groups, respectively.  Significant difference of mean MVD values     (P<0.001) between the early and advanced fibrotic groups revealed the association of angiogenesis and degree of myelofibrosis. Conclusion: MVD may be used to measure angiogenesis in myelofibrotic marrow along with other clinical and laboratory indices as a marker of disease activity in hematological malignancies, thus aiding disease prognosis. Bangabandhu Sheikh Mujib Medical University Journal 2023;16(1): 26-34

Degree of fibrosis and its association with angiogenesis in the myelofibrotic bone marrow

Background: Primary and secondary myelofibrosis has become a global burden due to its increased mortality and morbidity. Angiogenesis is a significant driving force in the development of fibrogenesis in the bone marrow, which leads to myelofibrosis. The microvascular density (MVD) with immunomarker CD34 can be used to assess the degree of angiogenesis. The objective of this study was to examine the association between degree of myelofibrosis and angiogenesis in hematological malignancies. Methods: Forty-six trephine biopsy specimens of various hematological malignancies with myelofibrosis were studied at the Department of Pathology of Bangabandhu Sheikh Mujib Medical University. Extent of myelofibrosis in each case was assessed by examining the reticulin and Masson’s trichrome stained sections using a semiquantitative grading system of bone marrow fibrosis (MF) within a scale of MF-0 to MF-3. Angiogenesis was measured by counting MVD in the ‘hotspots’ after immunostaining with CD34 antibody. Results: The trephine biopsy cases were grouped into early fibrotic (MF-1) and advanced fibrotic (MF-2,3) consisting of 16 (34.8%) and 30 (65.2%) patients, respectively. Angiogenesis was estimated as mean MVD count which revealed 16.7 ± 5.4 and 32.0 ± 11.5 in these groups, respectively.  Significant difference of mean MVD values     (P<0.001) between the early and advanced fibrotic groups revealed the association of angiogenesis and degree of myelofibrosis. Conclusion: MVD may be used to measure angiogenesis in myelofibrotic marrow along with other clinical and laboratory indices as a marker of disease activity in hematological malignancies, thus aiding disease prognosis. Bangabandhu Sheikh Mujib Medical University Journal 2023;16(1): 26-34

A critical review on control mechanisms, supporting measures, and monitoring systems of microgrids considering large scale integration of renewable energy sources

The numerous obstacles to large-scale integration of renewable energy sources (RESs) and the mitigating steps that need to be taken to overcome them in smart grid technology implementation are extensively discussed in this review article. Main focus is given on the control techniques in Microgrids, different supporting measures such as electric vehicles (EVs), energy storage systems (ESSs), and the monitoring techniques of Microgrid considering large scale renewable energy integration. The absence of physical factors like reactive power and frequency makes the DC microgrid less difficult than the AC microgrid. A comparison of the characteristics of centralized, decentralized, and distributed control arrangements reveals that the microgrid central controller (MGCC) bears the majority of the computational load and the cost of computation in centralized control, whereas local controllers (LCs) bear the least of the load and the cost of computation in completely decentralized control. Centralized and decentralized control also have less difficult implementations than distributed control, which has more complexity. Due to a number of challenges that are discussed in this article, the EV scenario in Bangladesh is rather challenging. The transportation sector has chosen vehicle to grid (V2G) approaches over other technologies due to a number of its advantages. In the event that a home energy storage system and an emergency backup storage system are required, V2G can reduce the cost of EVs and be modified for the local community. An autonomous power generation and distribution system is the main emphasis of a smart micro grid in this age, and internet of things (IoT) is utilized in various applications, such as micro grids, intelligent buildings, and intelligent control devices, for monitoring and tracking crucial data. Based on the topics that are presented in this article, it clearly demonstrates the state-of-the-art research in the area in question