Autoimmune pancreatitis presenting as obstructive jaundice

A 71 years cachexic male presented with sign symptoms of biliary tract obstruction. There was a large mass in the head of pancreases with raised CA 19.9. But elevated serum lipase raised the suspicion of paocreatitis. Elevated immunoglobu­lin IgG4 confmned this case as a auto immune aetiology. Initially there was much difficulty to differentiate auto immune pancreatitis from pancreatic carcinoma but after successful stenting and a course of corticosteroids, patient improved dramatically along with nonnalisation of all the radiological, bio-chemical and immunological parameters

Living on the Extreme Margin: Social Exclusion of the Transgender Population (Hijra) in Bangladesh

The transgender people (hijra), who claim to be neither male nor female, are socially excluded in Bangladesh. This paper describes social exclusion of hijra [The term is used in this abstract both in singular and plural sense] focusing on the pathway between exclusion and sexual health. In an ethnographic study, 50 in-depth interviews with hijra, 20 key-informant interviews, and 10 focus-group discussions (FGDs), along with extensive field observations, were conducted. The findings revealed that hijra are located at the extreme margin of exclusion having no sociopolitical space where a hijra can lead life of a human being with dignity. Their deprivations are grounded in non-recognition as a separate gendered human being beyond the male-female dichotomy. Being outside this norm has prevented them from positioning themselves in greater society with human potential and security. They are physically, verbally, and sexually abused. Extreme social exclusion diminishes self-esteem and sense of social responsibility. Before safer sex interventions can be effective in a broader scale, hijra need to be recognized as having a space on society's gender continuum. Hijra, as the citizens of Bangladesh and part of society's diversity, have gender, sexual and citizenship rights, that need to be protected

Acromegaly Presenting as Cardiac Failure - A Case Report

Acromegaly is characterized by chronic hypersecretion of growth hormone (GH) and is associated with increased mortality rate because of the potential complications such as cardiovascular disease, respiratory disease, or malignancy, which are probably caused by the long-term exposure of tissues to excess GH, for at least 10 years, before diagnosis and treatment. Here we are reporting a case of acromegaly who initially presented with features of left ventricular failure for which she got herself admitted in CCU and was treated conservatively. Later on, after clinical examination and investigations she was diagnosed as a case of mitral regurgitation due to cardiomyopathy caused by acromegaly. After the successful transsphenoidal resection of the pituitary microadenoma, the level of GH was normalized and heart failure improved. Key words: acromegaly; heart failure; Pituitary microadenoma. DOI: http://dx.doi.org/10.3329/bsmmuj.v4i2.8644 BSMMU J 2011; 4(2):122-12

Assessment of health-related quality of life of COVID-19 patients during follow-up

Background: The COVID-19 pandemic has had a significant impact on the quality of life of individuals worldwide. The aim of this study was to assess the health-related quality of life (HRQOL) and its associated factors among COVID-19 patients discharged from hospital. Methods: This facility-based cross-sectional study was conducted among laboratory confirmed COVID-19 patients who were discharged from medicine department of Bangabandhu Sheikh Mujib Medical University and did their first-month follow-up from April to September 2021. A validated Bengali version of International Quality of Life Assessment, Short form – 36 (SF-36) questionnaire was used to assess the HRQOL status. Univariate and multivariate analyses were done for identifying factors associated with low HRQOL. Result: Out of 225 patients, the mean (standard deviation) age was 36.9 (14.2) years and four in every ten patients were women. Out of eight subgroups, almost all scored averagely 79 out of 100. Older age, rural residence and severe to critical disease was reported as factors for low physical and mental component summary of SF-36. Conclusion: COVID-19 patients with older age, rural residence and having severe to critical disease condition need to be addressed critically as they have a higher chance of having low HRQOL status after COVID-19 infection. Bangabandhu Sheikh Mujib Medical University Journal 2023;16(2): 91-9

Short Communication - Methyl jasmonate induced overproduction of eleutherosides in somatic embryos of Eleutherococcus senticosus cultured in bioreactors

This study was concentrated on the production of eleutherosides and chlorogenic acid in embryogenic suspension cultures of Eleutherococcus senticosus by exposing them to different concentrations (50-400 \u3bcM) of methyl jasmonate (MJ) during the culture period. In the bioreactor cultures, eleutheroside content increased significantly by elicitation of MJ, however, the fresh weight, dry weight and growth ratio of embryos was strongly inhibited by increasing MJ concentrations. The highest total eleutheroside (7.3 fold increment) and chlorogenic acid (3.9 fold increment) yield was obtained with 200 \u3bcM MJ treatment. There was 1.4, 3.4 and 14.9 fold increase in the eleutheroside B, E, and E1 production respectively with such elicitation treatment. These results suggest that MJ elicitation is beneficial for eleutheroside accumulation in the embryogenic cell suspension cultures

Spectrum of thyroid dysfunctions among hospitalized patients with non-critically ill coronavirus disease 2019: A cross-sectional study

Background: Patients with coronavirus disease 2019 (COVID-19) particularly critically ill ones may present with different types of thyroid abnormalities. However, data regarding thyroid function tests (TFTs) among noncritical patients with COVID-19 are scarce. This study aimed to assess thyroid functions and their associations with the severity of illness among non-critically ill hospitalized patients with COVID-19. Methods: This cross-sectional study assessed TFTs in 87 (aged 18-65 years) RT-PCR-confirmed COVID-19 patients admitted to a tertiary-care hospital in Bangladesh. Diagnosis of non–critical illness and severity (mild, moderate, and severe) were defined by WHO’s interim guidance. Patients having known thyroid dysfunctions or taking drugs that may affect thyroid functions were excluded from the study. Serum TSH, FT4, and FT3 were measured by chemiluminescent immunoassay. Results: Majority of the patients (72%) had normal thyroid function. Among the abnormalities, the highest frequency was isolated hyperthyroxinemia (12.6%) and the rest were subclinical hypothyroidism (6.9%), subclinical thyrotoxicosis (4.6%), thyrotoxicosis (2.3%), isolated tri-iodothyroninemia (1.1%), and hypothyroidism (1.1%).  Serum TSH, FT4, and FT3 levels were similar across the spectrum of noncritical illness. No significant correlation was found between the inflammatory markers (C-reactive protein, ferritin, and D-dimer) and TSH levels. Conclusions: More than one-fourth of non-critically ill hospitalized patients with COVID-19 presented with a spectrum of thyroid abnormalities with isolated hyperthyroxinemia being the most common. However, TFTs had no significant associations with the severity of illness among noncritically ill patients with COVID-19. Bangabandhu Sheikh Mujib Medical University Journal 2023;16(2): 81-86

Living on the Extreme Margin: Social Exclusion of the Transgender Population (Hijra) in Bangladesh

The transgender people (hijra), who claim to be neither male nor female, are socially excluded in Bangladesh. This paper describes social exclusion of hijra [The term is used in this abstract both in singular and plural sense] focusing on the pathway between exclusion and sexual health. In an ethnographic study, 50 in-depth interviews with hijra, 20 key-informant interviews, and 10 focus-group discussions (FGDs), along with extensive field observations, were conducted. The findings revealed that hijra are located at the extreme margin of exclusion having no sociopolitical space where a hijra can lead life of a human being with dignity. Their deprivations are grounded in non-recognition as a separate gendered human being beyond the male-female dichotomy. Being outside this norm has prevented them from positioning themselves in greater society with human potential and security. They are physically, verbally, and sexually abused. Extreme social exclusion diminishes self-esteem and sense of social responsibility. Before safer sex interventions can be effective in a broader scale, hijra need to be recognized as having a space on society\u2019s gender continuum. Hijra, as the citizens of Bangladesh and part of society\u2019s diversity, have gender, sexual and citizenship rights, that need to be protected

S-Nitrosoglutathione reductase (GSNOR) mediates the biosynthesis of jasmonic acid and ethylene induced by feeding of the insect herbivore Manduca sexta and is important for jasmonate-elicited responses in Nicotiana attenuata

S-nitrosoglutathione reductase (GSNOR) reduces the nitric oxide (NO) adduct S-nitrosoglutathione (GSNO), an essential reservoir for NO bioactivity. In plants, GSNOR has been found to be important in resistance to bacterial and fungal pathogens, but whether it is also involved in plant–herbivore interactions was not known. Using a virus-induced gene silencing (VIGS) system, the activity of GSNOR in a wild tobacco species, Nicotiana attenuata, was knocked down and the function of GSNOR in defence against the insect herbivore Manduca sexta was examined. Silencing GSNOR decreased the herbivory-induced accumulation of jasmonic acid (JA) and ethylene, two important phytohormones regulating plant defence levels, without compromising the activity of two mitogen-activated protein kinases (MAPKs), salicylic acid-induced protein kinase (SIPK) and wound-induced protein kinase (WIPK). Decreased activity of trypsin proteinase inhibitors (TPIs) were detected in GSNOR-silenced plants after simulated M. sexta feeding and bioassays indicated that GSNOR-silenced plants have elevated susceptibility to M. sexta attack. Furthermore, GSNOR is required for methyl jasmonate (MeJA)-induced accumulation of defence-related secondary metabolites (TPI, caffeoylputrescine, and diterpene glycosides) but is not needed for the transcriptional regulation of JAZ3 (jasmonate ZIM-domain 3) and TD (threonine deaminase), indicating that GSNOR mediates certain but not all jasmonate-inducible responses. This work highlights the important role of GSNOR in plant resistance to herbivory and jasmonate signalling and suggests the potential involvement of NO in plant–herbivore interactions. Our data also suggest that GSNOR could be a target of genetic modification for improving crop resistance to herbivores