SPONTANEOUS BACTERIAL PERITONITIS: A COMMON AND LETHAL COMPLICATION OF CHRONIC LIVER DISEASE

Objective: To determine the frequency and pattern of spontaneous bacterial peritonitis in patients with chronic liver disease. Patients and Methods: Total fifty patients of age ≥12 years and either gender had liver cirrhosis (known / diagnosed cases) with ascites were included in this six months cross sectional study. The ascitic fluid analysis was done by taking 10 ml of ascitic fluid in a 10 CC sterilize syringe and ascitic fluid neutrophil count greater than 250 cells/µL was considered to be the case of SBP. The frequency and percentages was calculated for categorical variables whereas the numerical statistics were used to compute mean ±SD in SPSS 16. Results: During six months study period total fifty patients with chronic liver disease were evaluate for spontaneous bacterial peritonitis. The mean ± for age (years) & duration of chronic liver disease (years) for whole population was 45.62±5.98 & 7.93 ±2.41 respectively. The SBP observed in 37 (74%) while the common pathogen detected were E. Coli 10 (27%), S. aureus (18.9%) and Klebsiella 6 (16.2%) whereas regarding outcome 26 (70.2%) patients were recovered, recurrence observed in 5 (13.5%) and mortality in 6 (16.2%) respectively. Conclusion: SBP is a common and recurrent complication of cirrhosis and the ascitic fluid examination including culture and sensitivity is more sensitive and best tool as far as diagnose and management is concerned Keywords: Spontaneous bacterial peritonitis, Chronic liver disease, Hepatitis B and Hepatitis C

Developing a high-resolution gridded rainfall product for Bangladesh during 1901–2018

A high-resolution (1 km × 1 km) monthly gridded rainfall data product during 1901–2018, named Bangladesh Gridded Rainfall (BDGR), was developed in this study. In-situ rainfall observations retrieved from a number of sources, including national organizations and undigitized data from the colonial era, were used. Leave-one-out cross-validation was used to assess product’s ability to capture spatial and temporal variability. The results revealed spatial variability of the percentage bias (PBIAS) in the range of −2 to 2%, normalized root mean square error (NRMSE) 0.88 at most of the locations. The temporal variability in mean PBIAS for 1901–2018 was in the range of −4.5 to 4.3%, NRMSE between 9 and 19% and R-square in the range of 0.87 to 0.95. The BDGR also showed its capability in replicating temporal patterns and trends of observed rainfall with greater accuracy. The product can provide reliable insights regarding various hydrometeorological issues, including historical floods, droughts, and groundwater recharge for a well-recognized global climate hotspot, Bangladesh

Synthesis characterization and X-ray crystal structures of cis-1,4-diaminocyclohexane-platinum(II) nucleobase adducts

Platinum complexes of the type [Pt(cis-1,4-DACH)(L)2]X, where cis-1,4-DACH = cis-1,4-diaminocyclohexane; L = adenine (ade) (1), hypoxanthine (hyp) (2), 9-methylguanine (9-megua) (3), cytosine (cyt) (4), or 1-methylcytosine (1-mecyt) (5); and X = SO4 or Cl2 groups, were synthesized and characterized by elemental analysis and by 1H, 13C, and 195Pt nuclear magnetic resonance spectroscopy. The crystals of [Pt(cis-1,4-DACH)(9-megua)2]SO4[9-megua-H]2SO4 (3) and [Pt(cis-1,4-DACH)(1-mecyt)2]Cl2 · 6H2O (5) were also subjected to single-crystal X-ray diffraction. The base/PtN4 coordination plane dihedral angles were 74.55° and 85.61° in complex 3 and 78.12° and 81.80° in complex 5. The platinum had distorted square planar geometry in both complexes; the two adjacent corners were occupied by the two nitrogen atoms of cis-1,4-DACH, and the other two corners were occupied by the two N7 atoms of 9-megua in complex 3 and the two N3 atoms of 1-mecyt in complex 5. The cis-1,4-DACH, which has a unique twist-boat configuration, formed a seven-member chelating ring with platinum, which led to considerable strain during bidentate cis-1,4-DACH binding. Cations of both complexes 3 and 5 adopted C2 molecular symmetry. These adducts were the models for the intrastand cross-links that were relevant to the binding of the Pt(II) antitumor drugs to DNA. © 2006 Elsevier Ltd. All rights reserved

Estimating window period blood donations for human immunodeficiency virus type 1, hepatitis C virus, and hepatitis B virus by nucleic acid amplification testing in Southern Pakistan

Background: Recently, strategic planning was initiated by the National Blood Transfusion Services Pakistan to improve its blood bank facilities. Emphasis has been placed on appropriate screening of blood products. Located in the southern region, Aga Khan University Hospital is a 700-bed tertiary care academic institute with comprehensive blood banking. Screening of blood donors has been based on verbal screening and serologic testing to date. Additionally, the need of implementing nucleic acid testing (NAT) was considered in 2011 because of an upsurge in hepatitis epidemiology. The aim of this study was to analyze the efficacy of this additional donor screening program and to evaluate the impact of NAT on the yield and residual risk of transfusion-transmissible viral infections. Study Design and Methods: A total of 42,830 blood donations collected between 2011 and 2012 were screened for routine serologic assays. Only serologically negative donors (n = 41,304) were tested for NAT. The frequency of viral infections was evaluated through serologic techniques and NAT yield for viral agents was estimated for computing window period donors. Residual risk per million donors was computed for viral infections in seronegative blood donors. Results: Serologic work-up showed 1571 abnormal screening results in 1526 blood donors with the following results: hepatitis C virus antibodies (anti-HCV; n = 708), hepatitis B surface antigen (n = 555), human immunodeficiency virus antibodies (anti-HIV; n = 29), malaria (n = 30), VDRL (n = 249), and coinfection (n = 45). Thirty-five NAT-reactive samples were identified: HIV-1, one; HCV, 27; and hepatitis B virus (HBV), seven. Incident rates per 105 donors were highest for HCV (453.3) followed by HBV (171.5) and HIV (72.2). Calculated residual risk per million donors was highest at 1 in 10,900 for HBV, intermediate at 1 in 13,900 for HCV, and least at 1 in 62,600 for HIV.Conclusion: Incidence rates and estimated residual risk indicate that the current risk of transfusion-transmitted viral infections attributable to blood donation is relatively high in this country. The study recommends the parallel use of both serology and NAT screening of donated blood in countries that have high seroprevalence of these viral infections

ANKLE BRACHIAL INDEX (ABI) IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Objective: To estimate the ankle brachial index in patients with type 2 diabetes mellitus at tertiary care hospital Patients and Methods: All the diabetic population (≥ 3 years duration) between 40 - 80 years of age, either gender without previous diagnosis of peripheral arterial disease or clinical suggestive of intermittent claudication intermittent visited at tertiary care hospital from January 2016 to June 2016 & gave voluntary consent to participate in the study were recruited. The highest systolic blood pressure of lower limbs was divided by highest systolic blood pressure of lower limb was considered as ABI and the normal range is 0.9 and 1.2 while the ABI <0.9 was considered as low ABI (existence of arterial disease). The quantitative variables are presented as mean (deviation standard) and qualitative as frequencies and percentages by using statistical analyze program SPSS version 16. Results: During six months study period total fifty patients with type 2 diabetes mellitus were evaluate for ankle-brachial index. The mean ± for age (years) & duration of diabetes mellitus (years) for whole population was 60.52±8.92 & 9.95±3.85 respectively. The ABI was detected in 34 (68%) of the patients with male gender predominance 22 (64.7%) while the mean ± SD for ABI in male and female population was 0.51±2.31 and 0.63±1.94 respectively. Conclusion: Low ABI was detected in diabetic population and is strong risk factor for cardiovascular and cerebrovascular diseases. Keywords: Ankle brachial index, Diabetes mellitus and Peripheral vascular disease