Introduction: A caesarean delivery is a major surgery with risks of severe bleeding, scarring, infections, reactions to anesthesia and long-lasting pain. The aim of the study was to determine the predictors of caesarean delivery at hospitals in Rajshahi city, Bangladesh. Methods: Data was collected from 194 women who delivered at three private and one public hospital maternity wards in Rajshahi city between January and March 2013. A questionnaire was used to collect socio-demographic background of the mothers. Body mass index was computed to determine overweight and underweight status of the women. Results: The prevalence of caesarean delivery at the hospitals studied was 77.3%. Socio-demographic factors and nutrition status that were significantly associated with the type of birth delivery were considered as independent variables in a logistic regression model. Multiple logistic regression analysis showed that older women (age z 25 year) were more likely to undergo caesarean delivery than younger women. Women with higher education were more likely to have caesarean delivery as compared to women without formal schooling. Overweight women had a higher likelihood of caesarean delivery than women with normal weight and underweight. Conclusion: The study recorded a high prevalence of caesarean deliveries at the hospitals in Rajshahi city. Age, educational level and BMI status of the women were associated with caesarian deliveries.

Background: Kernicterus occurs in infants around the world. This study examined the outcomes of various treatments for neonatal hyperbilirubinemia (NH) used in the Khulna Medical College Hospital in Bangladesh. Methods: All of the jaundiced newborns in the neonatal ward between 2005 and 2008 were included in the study. Total serum bilirubin and fractional levels were measured in all cases, regardless of the degree of jaundice. NH was classified as mild, moderate or severe depending on the bilirubin level; mild NH was treated with a sunbath, moderate NH was treated with phototherapy, and severe NH was treated with exchange transfusion. Results: Of 1981 neonates, 426 (22%) were diagnosed with NH. Physiological jaundice (26.7%) was most common, followed by the jaundice of prematurity (20.9%). Haemolytic jaundice was primarily caused by ABO incompatibility (11.3%) and Rh incompatibility (5.4%). Exchange transfusion (ET) was performed in 22 patients; four (18.2%) died as a result of hazards that could have been avoided with skilled monitoring. Twelve (2.8%) individuals with jaundice died. Kernicterus developed in nine (2.1%) children, four of whom survived with neurological sequelae. Conclusion: ABO incompatibility is twice as common as Rh incompatibility. The majority of kernicterus patients died in the acute phase.

Chitinases (designated as SPCs) were isolated from „Shilbilati‟ potatoes, a potato prototype cultivated in Bangladesh by affinity chromatography on a chitin column. SPCs agglutinated rat erythrocytes at the minimum concentration of 7 μg/mL and showed toxicity against brine shrimp nauplii with the LC50 value of 20 μg/mL. The chitinases also agglutinated seven bacterial strains among the twelve as studied. Pseudomonas aeruginosa, Bacillus subtilis and Salmonella typhi were the most sensitive towards the SPCs and were agglutinated at 1.2, 2.5 and 5.0 μg/mL protein concentrations respectively. Antibacterial tests demonstrated that SPCs showed inhibitory activity against the pathogenic bacteria Staphylococcus aureus, Bacillus subtilis and Salmonella typhi. Antifungal activity was investigated by the disc diffusion method. Five fungal species (Candida albicans, Aspergillus niger, Fusarium vasinfectum, Aspergillus fumigatus and Aspergillus flavus) and two fungal genus (Penicillium and Mucor sp.) were examined in the assay. SPCs showed antifungal activity against Candida albicans, Fusarium vasinfectum and Penicillium sp.

In developing countries threat of cholera is a significant health concern whenever water purification and sewage disposal systems are inadequate. Vibrio cholerae is one of the responsible bacteria involved in cholera disease. The complete genome sequence of V. cholerae deciphers the presence of various genes and hypothetical proteins whose function are not yet understood. Hence analyzing and annotating the structure and function of hypothetical proteins is important for understanding the V. cholerae. V. cholerae O139 is the most common and pathogenic bacterial strain among various V. cholerae strains. In this study sequence of six hypothetical proteins of V. cholerae O139 has been annotated from NCBI. Various computational tools and databases have been used to determine domain family, protein-protein interaction, solubility of protein, ligand binding sites etc. The three dimensional structure of two proteins were modeled and their ligand binding sites were identified. We have found domains and families of only one protein. The analysis revealed that these proteins might have antibiotic resistance activity, DNA breaking-rejoining activity, integrase enzyme activity, restriction endonuclease, etc. Structural prediction of these proteins and detection of binding sites from this study would indicate a potential target aiding docking studies for therapeutic designing against cholera.
Bacteria ; Binding Sites ; Cholera ; Computer Simulation* ; Developing Countries ; DNA ; DNA Restriction Enzymes ; Drug Discovery ; Drug Resistance, Microbial ; Genome ; Humans ; Integrases ; Sewage ; Solubility ; Vibrio cholerae ; Vibrio cholerae O139* ; Water Purification

Great importance has been attributed to birth weight all over the world because it is considered as one of the best predictors of prenatal survival and a good indicator of quality life. The objective of this study was to determine the prevalence of low birth weight babies (LBW) and factors related to it in Baghdad city. A cross sectional study was carried out in four general hospitals in Baghdad city, Iraq. A total of 225 newborn babies, alive, singleton and without congenital malformation were selected randomly from these four general hospitals.The result of the study showed the prevalence rate of low birth weights was 21.3%. Mothers’ educational level, monthly family income, mothers with chronic hypertension, mothers with history of previous low birth weight infants and anemic mothers were significantly associated with low birth weight babies (P= 0.03, 0.01, 0.02,<0.01, 0.02) respectively. It is clearly evidenced the lack of equity in populations and disparity in socioeconomic status are common related factors for the low birth weight babies as can be seen as a public and global health problem.
Infant, Low Birth Weight ; Iraq

The unstable living situation in Iraq in the last 10 years after 2003 war affected the daily life of most Iraqis, and especially the children. The objective of this study was to explore the effects of an unstable living environment on children’s health. A community-based qualitative study was done to collect data from 20 mothers of children (age 7 to 8years old) through in-depth interview (IDI). Data was recorded using tape recorders and was later transcribed and analyzed using qualitative thematic analysis techniques. The majority of mothers interviewed said the past nine years of unstable security in the capital had affected their daily life; some mothers also expressed concern about their child’s nutritional status, their eating habits during the school day, and the unhealthy food being sold at school canteens. As a conclusion, the unstable living situations in Baghdad city after the last war had affected the cognitive and nutritional development of children. More precautions should be taken by parents to ensure their children safety in the future.
Economics ; Social Conditions ; Child ; Health ; Iraq

Myopericytoma are uncommon, slow-growing benign perivascular neoplasms that show hemangiopericytoma-like vascular pattern. We report a 52-year-male patient with a painless palpable nodule in the left thumb for the past 9 months. The mass, on the thenar aspect, was 15x12mm in size. X-ray revealed a soft tissue swelling with no bony association. The excised nodule was a non-capsulated, well-circumscribed vascular neoplasm composed of proliferating spindle to ovoid bland cells with eosinophilic cytoplasm. A concentric perivascular arrangement of the cells was seen interspersed by thin-walled, branching, staghorn blood vessels. Nuclear atypia, mitotic figures and necrosis were not observed. Immunohistochemistry revealed diffuse positivity of the tumour cells for smooth muscle actin while staining negative for CD34 and desmin - features suggestive of origin from the perivascular myoid cell. Morphological features of myopericytoma are shared with hemangiopericytoma, glomus tumors, myofibroma and solitary fibrous tumour which form the important differential diagnoses. It is a relatively newly described disease entity recognized by the World Health Organisation classification of tumours.

The plethora of genome sequence information of bacteria in recent times has ushered in many novel strategies for antibacterial drug discovery and facilitated medical science to take up the challenge of the increasing resistance of pathogenic bacteria to current antibiotics. In this study, we adopted subtractive genomics approach to analyze the whole genome sequence of the Fusobacterium nucleatum, a human oral pathogen having association with colorectal cancer. Our study divulged 1,499 proteins of F. nucleatum, which have no homolog's in human genome. These proteins were subjected to screening further by using the Database of Essential Genes (DEG) that resulted in the identification of 32 vitally important proteins for the bacterium. Subsequent analysis of the identified pivotal proteins, using the Kyoto Encyclopedia of Genes and Genomes (KEGG) Automated Annotation Server (KAAS) resulted in sorting 3 key enzymes of F. nucleatum that may be good candidates as potential drug targets, since they are unique for the bacterium and absent in humans. In addition, we have demonstrated the three dimensional structure of these three proteins. Finally, determination of ligand binding sites of the 2 key proteins as well as screening for functional inhibitors that best fitted with the ligands sites were conducted to discover effective novel therapeutic compounds against F. nucleatum.
Anti-Bacterial Agents ; Bacteria ; Binding Sites ; Colonic Neoplasms ; Colorectal Neoplasms ; Computer Simulation* ; Drug Delivery Systems ; Drug Discovery ; Fusobacterium nucleatum* ; Fusobacterium* ; Genes, Essential ; Genome ; Genome, Human ; Genomics ; Humans ; Ligands ; Mass Screening ; Mining* ; Proteome*

BACKGROUND: Interventional pain management (IPM) is a branch of medical science that deals with management of painful medical conditions using specially equipped X-ray machines and anatomical landmarks. Interventional physiatry is a branch of physical medicine and rehabilitation that treats painful conditions through intervention in peripheral joints, the spine, and soft tissues. METHODS: A cross-sectional study was conducted using three years of hospital records (2006 to 2008) from the Physical Medicine and Rehabilitation Department at Chittagong Medical College Hospital in Bangladesh, with a view toward highlighting current interventional pain practice in a tertiary medical college hospital. RESULTS: The maximum amount of intervention was done in degenerative peripheral joint disorders (600, 46.0%), followed by inflammatory joint diseases (300, 23.0%), soft tissue rheumatism (300, 23.0%), and radicular or referred lower back conditions (100, 8.0%). Of the peripheral joints, the knee was the most common site of intervention. Motor stimulation-guided intralesional injection of methylprednisolone into the piriformis muscle was given in 10 cases of piriformis syndrome refractory to both oral medications and therapeutic exercises. Soft tissue rheumatism of unknown etiology was most common in the form of adhesive capsulitis (90, 64.3%), and is discussed separately. Epidural steroid injection was practiced for various causes of lumbar radiculopathy, with the exception of infective discitis. CONCLUSIONS: All procedures were performed using anatomical landmarks, as there were no facilities for the C-arm/diagnostic ultrasound required for accurate and safe intervention. A dedicated IPM setup should be a requirement in all PMR departments, to provide better pain management and to reduce the burden on other specialties.
Bangladesh ; Bursitis ; Cross-Sectional Studies ; Exercise ; Hospital Records ; Injections, Intralesional ; Joint Diseases ; Joints ; Knee ; Methylprednisolone ; Muscles ; Pain Management ; Physical and Rehabilitation Medicine ; Piriformis Muscle Syndrome ; Radiculopathy ; Rheumatic Diseases ; Spine

OBJECTIVE: We investigated the effects of antipsychotics on immune-challenged peripheral blood mononuclear cell (PBMC) cultures. METHODS: Blood samples were collected from twelve patients with first-episode schizophrenia. The PBMCs were separated and cultures were prepared and stimulated with lipopolysaccharide (LPS) or polyinosinic:polycytidylic acid (poly[I:C]), and then separately treated with a typical antipsychotic (haloperidol) or atypical antipsychotic (clozapine, quetiapine, or risperidone). Pro-inflammatory (interferon gamma [IFN-gamma]) and anti-inflammatory (interleukin [IL]-4 and IL-10) cytokine levels were measured in the LPS- or poly(I:C)-stimulated PBMC cultures treated with antipsychotics. RESULTS: Haloperidol and quetiapine significantly increased the IL-4 levels (p<0.05) in LPS-stimulated PBMC cultures, while clozapine and quetiapine significantly enhanced the IL-4 levels (p<0.05) in poly(I:C)-stimulated PBMC cultures. Only treatment with haloperidol resulted in a significant increase in IL-10 production (p<0.05) in LPS-stimulated PBMC cultures, whereas clozapine, quetiapine, and risperidone treatment significantly increased IL-10 production (p<0.05) in poly(I:C)-stimulated PBMC cultures. All of the antipsychotics reduced the IFN-gamma level significantly (p<0.05) in LPS- and poly(I:C)-stimulated PBMC cultures. CONCLUSION: Antipsychotic treatment altered immune function by raising the levels of anti-inflammatory cytokines (IL-4 and IL-10) and suppressing the levels of pro-inflammatory cytokines (IFN-gamma).
Antipsychotic Agents* ; Cell Culture Techniques* ; Clozapine ; Cytokines ; Haloperidol ; Humans ; Interleukin-10 ; Interleukin-4 ; Lipopolysaccharides ; Risperidone ; Schizophrenia* ; Quetiapine Fumarate