Clinical and Biochemical Evaluation of Subacute (De Ouervain's) Thyroiditis

Background: Subacute thyroiditis is an important cause of thyrotoxicosis, often misdiagnosed as Graves’ disease and given anti-thyroid drugs. Etiological diagnosis can yield proper guideline of management and a good result. Objectives: To see the clinical, biochemical and isotope profile of subacute thyroiditis. Methods: A total of 45 cases [36 females, 9 males; age (mean ± SD): 33± 4.7 yr] were recruited from Endocrine outpatient department of Bangabandhu Sheikh Mujib Medical University (BSMMU) to see thyroid hormones and isotope scan. Results: Most of the patients had a history of sore throat (84.4%). All had painful thyroid gland with or without dysphagia, palpitation (93%), fever (91%), sweating and heat intolerance (80%) and IBS like symptoms was 46%. Among 36 females, 16 patients (44.4%) presented with oligomenorrhea/amenorrhea. Clinically palpable thyromegaly was present in 33 cases (73%), which was diffuse in 24 patients (73%), resting tachycardia in 35(78%) while anaemia in 23(51%). A few cases (13/45) had raised blood pressure. Elevation of thyroid hormone was found in 44(97.7%), but in most cases it was mild; little reduction of TSH (0.1-0.3mIU) was present in 43 (95%). Characteristically, low radio-iodine uptake (< 5%) in 2 hours and 24 hours was found in 100% and thyroid scan revealed uniform uptake in all cases. ESR was raised in 100% cases and leucocytosis was present in 9(20%). Conclusion: It is concluded that subacute thyroiditis can be diagnosed on careful clinical examination. As it is a self limiting disease and does not usually need any anti-thyroid medication, subacute thyroiditis should be excluded in thyrotoxic patients before initiating anti-thyroid drugs. Key words: Subacute thyroiditis; clinical and biochemical profile DOI: 10.3329/bsmmuj.v3i2.7057BSMMU J 2010; 3(2): 82-8

Comparison of ultrasonographically measured fetal interventricular septal thickness between diabetic and healthy mother

Background: During pregnancy, metabolic changes occur in response to increased nutrient needs of the fetus and mother, including progressive insulin resistance that can lead to gestational diabetes mellitus (GDM). GDM can result in fetal complications. This study aimed to compare fetal interventricular septal thickness, measured by ultrasound, between diabetic and healthy mothers. Methods: This cross-sectional study was conducted at the department of radiology and imaging, BIRDEM, Dhaka, Bangladesh. A total of 334 subjects were enrolled in this study as per inclusion criteria. The study duration was 2 years; from July 2012 to June 2014. All study subjects were divided into 3 groups named group A, group B, and group C. 167 non-diabetic, 84 controlled diabetics, and 83 uncontrolled diabetic mothers were considered as group A, group B, and group C respectively. Data were analyzed by SPSS computed program. Results: In this study, 47.9% of subjects in group A were ≤25 years old, while 52.4% of group B and 53.0% of group C were in the 26-30 age range. The mean age was 25.9±3 years in group A, 25.5±2.9 years in group B, and 25.2+3.3 years in group C, with no statistically significant difference between the three groups (p>0.05). The mean gestational age was similar across the three groups, with no statistically significant difference (p>0.05). However, the mean fetal interventricular septal thickness was significantly different between the groups, with group A and B having similar thicknesses, while group C had a significantly larger thickness (p<0.05). The difference in fetal interventricular septal thickness was also statistically significant between the three groups at 32 weeks of gestational age (p<0.05). Conclusions: In this study, the fetal interventricular septal thickness was significantly higher in uncontrolled diabetic mothers followed by controlled diabetic and non-diabetic and almost alike between non-diabetic and controlled diabetic mothers. The study also revealed that M-mode ultra-sonogram measurement of interventricular septal thickness can be included in routine scanning during the third trimester

Effective Cross-linking Dyeing Method for Jute Fabric with Reactive Dyes

With a view to develop an effective dyeing method for jute fabric, jute fabric known as Carpet Backing Cloth (CBC), made from jute fiber, was first desized, scoured, and bleached with hydrogen peroxide. Simultaneous dyeing and finishing methods were carried out using various reactive dyes with some cross-linking agents like Fixapret CPN, Fixapret ECOs of BASF, and Indosol E-50 Powder (Sandoz) along with some catalysts (MgCl2, 6H2O) and softening agent. Three types of cross-linking methods such as dry, moist, and wet were employed. The cross-linking method was optimized by treatment of bleached CBC with different concentrations of cross-linking agents and catalysts applying pad-dry-cure method at different temperatures. Significant improvement was found in dye fixation rate, dye fastness (washing, rubbing, light and perspiration) properties, and tensile strength of cross-linked dyed jute fabric. Regarding all dyeing and physical properties, Indosol E-50 powder along with various reactive dyes achieved highly satisfactory results. Fixapret CPN may also be comparable to Indosol E-50 powder

Castlemans Disease - A Rare Cause of Pyrexia of Unknown Origin (PUO): Case Report

Pyrexia of unknown origin (PUO) is a common problem in medical practice. Patients suffer from fever for long period but initial relevant investigations remain normal. Infection is the most common cause of PUO in developing countries. Other causes are lymphoma, myeloma, connective tissue diseases (CTD), sarcoidosis and malignancy etc. In our country, where no cause can be identified, a usual practice is to start anti-tubercular drugs. We report a patient who was suffering from prolonged fever and usual investigations were within normal limit except high erythrocyte sedimentation rate. In spite of having 6 months anti-tubercular drugs, the patient did not respond. Thorough examination revealed a paraaortic mass which was reconfirmed by ultrasound of abdomen. Laparotomy revealed a mesenteric lymph node that was removed. Histopathologically it was diagnosed as a case of CASTLEMAN'S DISEASE which is a rare cause of PUO. On removal of the lymph node, the patient improved dramatically. Key words: Castleman's disease; PUO DOI: 10.3329/bsmmuj.v2i2.4764 BSMMU J 2009; 2(2): 85-8

Contribution to the knowledge of genome size evolution in edible blueberries (genus Vaccinium)

BACKGROUND: Vaccinium is one of the largest genera (ca. 500 species) of Ericaceae, well known for its edible and ornamental uses. Although there is certain karyological knowledge, information about genome size (GS) is scarce in the genus. OBJECTIVE: The main goal is providing GS data for several Vaccinium species with prevalence in Europe and Western Asia and analysing global GS variation in the genus, considering available data and phylogenetic context. METHODS: New GS assessments were obtained by flow cytometry and chromosome counts were verified. Phylogenetic analyses (using nuclear ITS, and chloroplastic matK and ndhF) were performed by Bayesian inference and reconstruction of ancestral GS by maximum parsimony. RESULTS: We obtained GS data for five Vaccinium species (13 populations). Three species are reported for the first time. Values (2C) ranged between 1.16-1.47 pg at the diploid (2n = 24) and between 3.13-3.16 pg at the tetraploid (2n = 48) levels. The five species here investigated have been placed and analysed in a reconstructed phylogenetic background (including 68 taxa). CONCLUSIONS: GS values of Vaccinium can be considered "very small". The preliminary reconstruction of ancestral GS would point to a reduction in Vaccinium, although more data is needed to establish global GS evolutionary trend in the genus

Clinical and Biochemical Evaluation of Subacute (De Ouervain's) Thyroiditis

Background: Subacute thyroiditis is an important cause of thyrotoxicosis, often misdiagnosed as Graves’ disease and given anti-thyroid drugs. Etiological diagnosis can yield proper guideline of management and a good result. Objectives: To see the clinical, biochemical and isotope profile of subacute thyroiditis. Methods: A total of 45 cases [36 females, 9 males; age (mean ± SD): 33± 4.7 yr] were recruited from Endocrine outpatient department of Bangabandhu Sheikh Mujib Medical University (BSMMU) to see thyroid hormones and isotope scan. Results: Most of the patients had a history of sore throat (84.4%). All had painful thyroid gland with or without dysphagia, palpitation (93%), fever (91%), sweating and heat intolerance (80%) and IBS like symptoms was 46%. Among 36 females, 16 patients (44.4%) presented with oligomenorrhea/amenorrhea. Clinically palpable thyromegaly was present in 33 cases (73%), which was diffuse in 24 patients (73%), resting tachycardia in 35(78%) while anaemia in 23(51%). A few cases (13/45) had raised blood pressure. Elevation of thyroid hormone was found in 44(97.7%), but in most cases it was mild; little reduction of TSH (0.1-0.3mIU) was present in 43 (95%). Characteristically, low radio-iodine uptake (< 5%) in 2 hours and 24 hours was found in 100% and thyroid scan revealed uniform uptake in all cases. ESR was raised in 100% cases and leucocytosis was present in 9(20%). Conclusion: It is concluded that subacute thyroiditis can be diagnosed on careful clinical examination. As it is a self limiting disease and does not usually need any anti-thyroid medication, subacute thyroiditis should be excluded in thyrotoxic patients before initiating anti-thyroid drugs. Key words: Subacute thyroiditis; clinical and biochemical profile DOI: 10.3329/bsmmuj.v3i2.7057 BSMMU J 2010; 3(2): 82-8

Insulinoma Presenting with Psychiatric Manifestations: A Case Report

Insulinomas, the most common of pancreatic endocrine tumors, usually present with neuroglycopenic and adrenergic features. Chronic or long standing recurrent hypogycaemia can produce intellectual deterioration and neuropsychiatric manifestations. Diagnosis of insulinoma relies on clinical features along with laboratory tests and imaging investigations to aid in localization. A 32-year-old male who presented with prominent neuropsychiatric manifestations and received anti-epileptics as a case of epilepsy and was ultimately diagnosed as insulinoma is reported here. The patient experienced fasting hypoglycemia with neuropsychiatric manifestations; computerized tomography (CT scan) and magnetic resonance imaging (MRI) revealed a diffusely enhanced mass in the head area of pancreas which was histopathologically found to be an insulinoma after hand assisted laparoscopic enucleation. Surgical excision is the treatment of choice and is curative in most cases. Key words: Insulinoma; Psychiatric Manifestation.DOI: 10.3329/bsmmuj.v2i1.3710 BSMMU J 2009; 2(1): 39-4

Fine needle aspiration cytological diagnosis of thyroid nodule with its clinical correlation

Background: Nodular goiter is common in Bangladesh. Thyroid nodules are important for their malignant potential especially the solitary and cold ones and when functionally euthyroid. Objectives: This study was designed to investigate the frequency of malignancy and cellular aberration detected by fine needle aspiration cytology (FNAC) in euthyroid nodules and its correlation with clinical findings. Methods: Subjects with nodular goiter attending Endocrine out patient department [n=150, nonpregnant, age (mean± SD): 37±12 years; sex (male: female): 21:129] were recruited for this study. All subjects underwent clinical risk stratification, estimation ofFT4 and TSH as well as ultrnsonogram (USG) and isotope scan of thyroid. Thyroid nodules were categorized into malignant, suspicious, benign and indeterminant on the basis of cellular character by FNAC. Statistical analysis was done by Chi-square and multiple regression analysis. Results: Patients were mostly females (86%) and 4.7% had family history of thyroid problems. Some had recent changes of size (14.7%), pain in the nodule (4%) and dysphagia (6%). Nodules were solitary in 45.3% and the rest (54.7%) had multinodular goiter. Enlarged regional lymph node was found in 12.7% patients. About 41 % were partially-cold followed by cold nodules (26.7%), patchy (16.7%), isoform (12%) and hot (4%) by isotope scan. Frequency of malignant (10%) character was highest in cold nodules followed by uniform (5.6%), patchy (4.0%) and partially cold (1.6%) while none in hot nodules; which were 22.5%, 11.1 %, 4.0%, 9.8% and 16.7% respectively for suspicious nodules. About 17% showed cellular aberration and 4.7% were clearly malignant, whereas 124 (82.7%) were benign. Of the malignant, 4 were solitary and 3 were multinodular; which were 10 and 9 among the suspicious ones. A significant number (77%, 20 out of 26) among the malignant/suspicious nodules fell into moderate to high risk category (x2=22.861, p&lt;0.001), while 23.1 % of the FNAC proven malignant/suspicious nodules were of low risk category. Enlarged lymph nodes (p&lt;0.001), increased diameter of nodules of &gt;4 cm (p=0.039) and recent changes in nodular size (p=0.042) were independently and signifi­cantly related to cellular aberration. Conclusions: FNAC is a useful tool for cellular diagnosis of thyroid nodules. Clinical suspicion for malignancy strongly correlates with the FNAC findings. But a good number of clinically Low risk categories would escape malignant cellular character unless FNAC is done

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

Sex-chrom, a database on plant sex chromosomes

This work has been supported by the Dirección General de Investigación Científica y Técnica (Spanish Government: CGL2016-75694-P AEI/FEDER, UE; CGL2017-84297-R), by the Generalitat de Catalunya (‘Ajuts a grups de recerca consolidats’ 2017SGR01116’), by the Czech Science Foundation (grants 16-08698S, 18-06147S and 19-03442S) and by CIJA PRESERVATION, SL. SG benefitted from a Ramón y Cajal contract (RYC-2014-16608) from the government of Spain, and SB and NS received Erasmus + grants from the European Union.Introduction Types of plant sex chromosomes, sex determination systems and their diversity Model systems in sex chromosome research Materials and Methods Information sources Data mining Database web environment and construction Results and Discussion Future directions Acknowledgements Author contribution