bluuebunny/crossref_metadata_2025 huggingface dataset:
A1C and Cardiovascular Outcomes in Type 2 Diabetes
Authors: Colayco Danielle C. , Niu Fang , McCombs Jeffrey S. , Cheetham T. Craig
Published: October 2010

OBJECTIVE

Type 2 diabetes is associated with increased cardiovascular risk. The role of aggressive glycemic control in preventing cardiovascular events is unclear. A nested case-control study design was used to evaluate the association between average A1C and cardiovascular outcomes.

RESEARCH DESIGN AND METHODS

Adults with type 2 diabetes were identified among members of Kaiser Permanente Southern California. Type 2 diabetes was identified based on ICD-9 diagnosis codes and either A1C >7.5% or prescriptions for hypoglycemic agents. Case subjects were defined based on nonfatal myocardial infarction, nonfatal stroke, or death attributed to cardiovascular events during a 3-year window. Four type 2 diabetes control subjects were matched to each case subject based on age, sex, and index date for the corresponding case. A conditional logistic regression model was used to estimate the odds ratio of cardiovascular events and compare three patient groups based on average A1C measured in the preindex period (≤6, >6–8, >8%).

RESULTS

A total of 44,628 control subjects were matched to 11,157 case subjects. Patients with an average A1C ≤6% were 20% more likely to experience a cardiovascular event than the group with an average A1C of >6–8% (P < 0.0001). Patients with an average A1C >8% experienced a 16% increase in the likelihood of a cardiovascular event (P < 0.0001). We found evidence of statistical interaction with A1C category and LDL level (P = 0.0002), use of cardiovascular medications (P = 0.02), and use of antipsychotics (P = 0.001).

CONCLUSIONS

High-risk patients with type 2 diabetes who achieved mean A1C levels of ≤6% or failed to decrease their A1C to <8% are at increased risk for cardiovascular events.
Evaluation of treatment with a combination of azathioprine and prednisone in dogs with meningoencephalomyelitis of undetermined etiology: 40 cases (2000-2007)
Authors: Wong Michael A. , Hopkins Andrew L. , Meeks John C. , Clarke Jeff D.
Published: October 2010

Objective—To evaluate outcome of treatment with a combination of azathioprine and prednisone in dogs with meningoencephalomyelitis of undetermined etiology (MUE).

Design—Retrospective case series.

Animals—40 dogs.

Procedures—Medical records of dogs with MUE treated with prednisone and azathioprine were evaluated with regard to response, survival, and adverse effects.

Results—All dogs improved during treatment. Twenty-four (60%) dogs had a complete response (resolution of clinical signs), and the other 16 (40%) dogs had a partial response (improvement but not resolution of signs). Most dogs that achieved a complete response remained neurologically normal. Six dogs remained stable after a partial response. Eleven dogs had a relapse of clinical signs. Twenty dogs died during the study period, 18 survived, and 2 were lost to follow-up monitoring. Median survival time was 1,834 days (range, 50 to 2,469 days). Survival time was significantly longer for dogs that had a complete response than for those that did not. Survival time was significantly shorter for dogs that relapsed than for those that did not. The most common adverse effects included weight gain, thinning of the hair, and elevated activities of liver enzymes, all of which may have been attributed to concurrent corticosteroid administration. Less common adverse effects included diabetes mellitus, keratoconjunctivitis sicca, mammary gland adenoma, lymphoma, and hepatic masses.

Conclusions and Clinical Relevance—Azathioprine appeared to be a safe and potentially effective adjunct to prednisone for treatment of dogs with MUE. Prospective, double-blinded, controlled studies with histologic confirmation are warranted to substantiate these findings.
Preliminary Study of Self-Reported Experience of Physical Aggression and Bullying of Boys Who Stutter: Relation to Increased Anxiety
Authors: Blood Gordon W. , Blood Ingrid M.
Published: October 2010

This study examined the relationship of self-reported anxiety and vulnerability to bullying for 18 children who stuttered and 18 children who did not stutter. More children who stuttered were at significantly higher risk of experiencing bullying behavior (61%) than children who did not stutter (22%); 39% of children who stuttered scored at least one standard deviation above the mean on the Revised Children's Manifest Anxiety Scale, suggestive of higher anxiety. In contrast, only 6% of children who did not stutter scored at least one standard deviation above the mean. The correlation was .82 for children who stuttered between greater vulnerability to bullying and self-reported anxiety. A bidirectional relationship is hypothesized between high anxiety and bullying of children who stutter.
Core Values and Evaluation Processes Associated with Academic Tenure
Authors: Balogun Joseph A. , Sloan Patricia E. , Germain Monique
Published: October 2010

This study replicated the 1989 national study by the Carnegie Foundation for the Advancement of Teaching in which the relative importance of teaching, scholarship, and service in tenure decisions was examined. The deans of the National League for Nursing accredited programs ( N = 187) and deans of Allied Health programs belonging to the Association of Schools of Allied Health Professions ( N = 75) were surveyed to identify the core values and evaluation processes used in granting tenure. Most deans who participated stated it is difficult to achieve tenure in the absence of publication in refereed journals. The number of journal publications, reputation of the journal, presentation at scientific conferences, and published reviews of the scholars' books are considered critical in granting tenure. Furthermore, advising students, service in the department and university, and course evaluation by students were considered critical to granting tenure. Overall, the opinions of the nursing and allied health deans on the core values and the evaluation processes used in tenure decisions were similar, but divergent from those of the “health sciences” faculty members in the Carnegie Foundation study. These findings suggest a shift in the criteria used in tenure decisions today.
Perceived Support in School Adjustment
Authors: Yoon Jina S. , Carcamo Amy
Published: October 2010

This study examined the relationship between support by parents and teachers and school attachment and involvement in the first year of middle school for 157 sixth graders in a predominantly African-American urban middle school. Results suggested the importance of parental support in school attachment and involvement during early adolescence. Teachers' support was a significant predictor of overall school attachment ( R2 = .03) beyond the variance explained by parental support ( R2 = .11).
Mood after Various Brief Exercise and Sport Modes: Aerobics, Hip-Hop Dancing, ICE Skating, and Body Conditioning
Authors: Kim Sungwoon , Kim Jingu
Published: October 2010

To investigate the potential psychological benefits of brief exercise and sport activities on positive mood alterations, 45 Korean high school and 232 undergraduate students enrolled in physical education and stress management classes voluntarily participated and were randomly assigned to one of four activities: aerobic exercise, body conditioning, hip-hop dancing, and ice skating. Mood changes from before to after exercise (2 pm to 3 pm) were measured based on a Korean translation of the Subjective Exercise Experiences Scale. The findings suggested that the aerobics and hip-hop dancing groups rated positive well-being higher than the body conditioning and ice skating groups. Immediately after exercise, psychological distress was rated lower in the aerobics and hip-hop dancing groups, as was fatigue.
Motivation, Stress, Anxiety, and Cortisol Responses in Elite Paragliders
Authors: Filaire Edith , Rouveix Matthieu , Alix Deborah , Le Scanff Christine
Published: October 2010

In this study metamotivational dominance (measured with the Telic Dominance Scale), precompetition anxiety (evaluated with the CSAI-2), perceived stress (measured with the Perceived Stress Scale), and cortisol responses by 10 paragliding competitors prior to and following a paragliding competition were examined. Saliva was collected for each subject for cortisol analysis on eight occasions: during a resting day (baseline values) and prior to and after competition. Analysis indicated subjects were all paratelic-dominant (characterized by a desire for high arousal, a focus on the present). Scores were high on the Perceived Stress Scale and cognitive anxiety (a telic emotion). Cortisol values showed a significant increase early on the day of the competition and remained elevated all the day, with highest concentrations at the start. Participants' cognitive anxiety and cortisol responses were significantly correlated .79 just before the jump and the direction of the cognitive anxiety was rated as facilitative of performance. These results may suggest that the more frequently the subject is playful in life, the more cortisol they produce when aroused in a less frequent telic state.
Training Motor Skills of Children with Low Vision
Authors: Aki Esra , Atasavun Songül , Turan Ayşe , Kayihan Hülya
Published: October 2010

The aim of this study was to study the effectiveness of a motor training program for visually impaired children. 40 children with low vision took part in the study. 20 children (10 boys, 10 girls), mean age 8:9 yr.:mo. ( SD = 1:6), were in a Training group and 20 children (10 boys, 10 girls), mean age 8:10 yr.:mo. ( SD = 1:65), were in a Home Training group. The Snellen Chart and Bruininks Oseretsky Motor Proficiency Test were used for assessment. Training program included training balance, coordination, strength, visuomotor control, and finger dexterity. Significant differences were found on all skills after training in the Training group, but no significant differences were observed, other than visual motor control, in the Home Training group. Children with low vision have some useable vision and learning to use the available vision depends on proper rehabilitation.
Development of Orofacial Praxis of Children from 4 to 8 Years of Age
Authors: Bearzotti F. , Tavano A. , Fabbro F.
Published: October 2010

Orofacial praxis is the ability to plan and execute movements or sequences of voluntary movements, meaningful or not, using the muscles of the pharyngo-buccofacial system or the orofacial region. An original test was developed, the Orofacial Praxis Test, consisting of 36 gestures, 24 single and 12 complex, elicited through verbal and imitative request. The test was administered to 93 normally developing Italian children ages 4 to 8 yr. to assess development of orofacial praxis. Analysis showed a progressive development of the orofacial praxic ability by type of gesture and examiner's request: (1) the imitation modality is more facilitating than a verbal request modality, especially for children ages 4 or 5 years; (2) a consistent mastery of sequences of gestures and oroverbal movements is in place by age 6 years. The analysis of the orofacial region may be helpful in identifying persistent speech difficulties and developmental coordination disorders.
Young Children Making Sense of Racial and Ethnic Differences
Authors: Park Caryn C.
Published: October 2010

The research on young children and race has previously relied on Piagetian developmental concepts to describe ages and stages in the development of children’s racial and ethnic understandings, leaving uninvestigated the situated meaning and consequences of children’s learning. Drawing from a qualitative study of young children’s (ages 3.5 to 5.5) day-to-day experiences with racial and ethnic diversity in an early childhood classroom, this article takes a critical sociocultural approach to examine children’s language and social interactions. Classroom participant observation and interviews with six focal students revealed children actively constructing understandings by appropriating various social tools. The children in this study enacted racial and ethnic identities, constructed theories about how differences operate, formed peer groups, and made sense of the multitude of messages they received about diversity.
Marginal Mean Weighting Through Stratification: Adjustment for Selection Bias in Multilevel Data
Authors: Hong Guanglei
Published: October 2010

Defining causal effects as comparisons between marginal population means, this article introduces marginal mean weighting through stratification (MMW-S) to adjust for selection bias in multilevel educational data. The article formally shows the inherent connections among the MMW-S method, propensity score stratification, and inverse-probability-of-treatment weighting (IPTW). Both MMW-S and IPTW are suitable for evaluating multiple concurrent treatments, and hence have broader applications than matching, stratification, or covariance adjustment for the propensity score. Furthermore, mathematical consideration and a series of simulations reveal that the MMW-S method has incorporated some important strengths of the propensity score stratification method, which generally enhance the robustness of MMW-S estimates in comparison with IPTW estimates. To illustrate, the author applies the MMW-S method to evaluations of within-class homogeneous grouping in early elementary reading instruction.
Thermal Induced Clustering of Polysilicon Film on Silicon Nitride/Silicon Dioxide Bed on Silicon Substrate
Authors: Lamichhane Shobha Kanta
Published: October 2010

Polysilicon (PS) grains are clustered in an order in the presence of thermal doping of boron in low pressure chemical vapour deposition (LPCVD). PS layer is lying on Silicon Nitride/Silicon dioxide bed over (100) silicon substrate. The doped PS at different temperatures has been analyzed for the grain size and the shape of the clusters, employing non-contact mode Atomic Force Microscopy (AFM). The grain size of the PS remains intact without a significant change with increasing doping temperature. A substantial increase in the cluster size and its density of the grains has been observed. The cluster formation mechanism induced by thermal variation is discussed in the context of recorded AFM images. The clusters lead to PS rings comprising of grains of the size of 100 nm. Keywords: Doping; Polisilicon; Nanoscale; AFM; MEMS; LPCVD; Contactmode. DOI: 10.3126/sw.v8i8.3839 Scientific World Vol.8(8) 2010 pp.10-14
Anaerobic Digestion of Sewage Sludge Mixture for the Reduction of Indicator and Pathogenic Microorganisms
Authors: Poudel Ram Chandra , Joshi Dev Raj , Dhakal Nawa Raj , Karki Amrit Bahadur
Published: October 2010

Anaerobic digestion is a technique used for the sanitizing the sewage sludge before its final disposal. We determined the fate of indicators and pathogens in sewage sludge mixture subjected to mesophilic anaerobic digestion (MAD) and ambient anaerobic digestion (AAD) for 30 and 35 days respectively by culture based microbiological methods (bacteria) and formal-ether sedimentation technique (parasites). While monitoring the organisms at five days intervals, MAD effectively reduced most of the bacteria and parasites to undetectable levels than AAD. Interestingly, the highest reductions in load were observed for faecal coliforms (5.16 log10 cfu/ml) in the sewage sludge mixture of MAD which met the class A biosolid standard (USEPA). Like wise, the bacterial load reductions were negatively correlated and statistically significant (p< 0.005) with days of both digestions and the relation between total coliforms load and days of MAD experienced higher correlation coefficient (r= -0.992) and R2 (0.984) values which shows higher validity in regression model. Therefore, MAD can be considered as a promising method for reduction of indicator and pathogenic microorganisms in sewage sludge mixture. Keywords: Anaerobic digestion; Correlation coefficient; Regression model; Sewage sludge. DOI: 10.3126/sw.v8i8.3848 Scientific World Vol.8(8) 2010 pp.47-50
Stereotactic depth electrode investigation of the insula in the evaluation of medically intractable epilepsy
Authors: Desai Atman , Jobst Barbara C. , Thadani Vijay M. , Bujarski Krzysztof A. , Gilbert Karen , Darcey Terrance M. , Roberts David W.
Published: October 2010

Object

The authors describe their experience with stereotactic implantation of insular depth electrodes in patients with medically intractable epilepsy.

Methods

Between 2001 and 2009, 20 patients with epilepsy and suspected insular involvement during seizures underwent intracranial electrode array implantation at the authors' institution. All patients had either 1 or 2 insular depth electrodes placed as part of an intracranial array.

Results

A total of 29 insular depth electrodes were placed using a frontal oblique trajectory. Eleven patients had a single insular electrode placed and 8 patients had 2 insular electrodes placed unilaterally. One patient had bilateral insular electrodes implanted. Postoperative imaging demonstrated satisfactory placement in all but 1 instance, and there was no associated morbidity or mortality. Fourteen patients underwent a subsequent resection, involving the frontal lobe (9 patients), temporal lobe (4), or frontotemporal lobes (1), and of these, 11 currently have Engel Class I outcome. Two patients (10%) had seizures originating within the insula and another 5 patients (25%) demonstrated early specific insular involvement. Neither patient with an insular seizure focus went on to resection. All 5 of the patients with early specific insular involvement underwent an insula-sparing resective procedure with Engel Class I outcome in all cases.

Conclusions

Stereotactic placement of insular electrodes via a frontal oblique approach is a safe and efficient technique for investigating insular involvement in medically intractable epilepsy. The information obtained from insular recording can be valuable for appreciating the degree of insular contribution to seizures, allowing localization to the insula or clearer implication of other sites.
Risk of ventriculostomy-related hemorrhage in patients with acutely ruptured aneurysms treated using stent-assisted coiling
Authors: Kung David K. , Policeni Bruno A. , Capuano Ana W. , Rossen James D. , Jabbour Pascal M. , Torner James C. , Howard Matthew A. , Hasan David
Published: October 2010

Object

Intracranial stenting has improved the ability to treat wide-neck aneurysms via endovascular techniques. However, stent placement necessitates the use of antiplatelet agents, and the latter may complicate the treatment of patients with acutely ruptured aneurysms who demonstrate hydrocephalus and require ventriculostomy. Antiplatelet agents in this setting could increase the incidence of ventriculostomy-related hemorrhagic complications, but there are insufficient data in the medical literature to quantify this potential risk. The aim of this study was to directly quantify the risk of ventriculostomy-related hemorrhage in patients with acute aneurysmal subarachnoid hemorrhage treated with stent-assisted coiling.

Methods

The authors retrospectively identified 131 patients who underwent endovascular treatment for an acutely ruptured aneurysm as well as ventriculostomy or ventriculoperitoneal (VP) shunt placement. The rate of hemorrhagic complications associated with ventriculostomy or VP shunt insertion was compared between patients who underwent coiling without a stent (Group 1) and those who underwent stent-assisted coiling and dual antiplatelet therapy (Group 2).

Results

One hundred nine ventriculostomies or VP shunt placement procedures were performed in 91 patients in Group 1, and 50 procedures were undertaken in 40 patients in Group 2. The rates of radiographic hemorrhage and symptomatic hemorrhage were significantly higher in Group 2 (32% vs 14.7%, p = 0.02; and 8% vs 0.9%, p = 0.03, respectively). On multivariate analyses, Group 2 had 3.42 times the odds of a radiographic hemorrhage (95% CI 1.46–8.04, p = 0.0048) after adjusting for antiplatelet use prior to admission.

Conclusions

The application of dual antiplatelet therapy in stent-assisted coiling of acutely ruptured aneurysms is associated with an increase in the risk of hemorrhagic complications following ventriculostomy or VP shunt placement, as compared with its use in a coiling procedure without a stent.
Non-Hodgkins Lymphoma in Pregnancy: A Case Report
Authors: Habib ASMA , Hossain Md Mofazzel
Published: October 2010

Non-Hodgkin lymphoma with concurrent pregnancy produces management dilemma regarding obstetrical aspect and chemoradiation for the disease itself. Successful pregnancy outcome depends upon several factors. Stage of Non-Hodgkin Lymphoma at presentation, gestational age at the time of diagnosis, response to chemotherapy, presence of compression symptoms or systemic B symptoms, concomitant obstetric complications emerging during antenatal follow-up, teratogenic /developmental defects of the unborn baby and its sequel, cardiotoxicity of Doxorubicin in particular are among the various factors affecting management and prognosis of each case. This case report delineates the management of a patient diagnosed as Non- Hodgkin's lymphoma at 18 weeks of gestation with a successful foetal outcome and ultimate demise of the patient from progressive disease eight months after delivery. DOI: 10.3329/bjog.v24i1.6324 Bangladesh J Obstet Gynaecol, 2009; Vol. 24(1) :27-31
Therapeutic Response of Wilsons disease to D-Penicillamine in Paediatric Population: A one year follow-up study
Authors: Saha NC , Sultana A , Mollah MAH , Begum T , Rahman AKMM , Fatmi LE
Published: October 2010

Objectives: The objective of this study was to observe the outcome of patients treated with penicillamine. Design: Intervention type of study Setting: Department of Paediatrics, Dhaka Medical College Hospital Study period: January 2007 to December 2008. Study subjects: Sixteen diagnosed cases of Wilson's disease as per inclusion criteria. Intervention: D-penicillamine was started in a low dose, which was titrated gradually. The clinical and biochemical parameters were evaluated to look for the response to treatment. Results: A total of 16 cases were included. Among them 12 were male and 4 were female. The mean (± SD) of age of the patients was 10 (± 2.34) years. Consanguinity between parents was present in 44% (n=7). The hepatic and neurological variety of WD were 56 % (n=9) and 44% (n=7) respectively. The K-F ring was present in 75% (n=12/16) of WD cases. The excretion of 24 hrs urinary copper was steadily increased from discharge till second follow-up in response with increasing dose of penicillamine, thereafter the value was declining gradually till final follow-up at 1 year. Regarding outcome, 7 patients improved of which 4 were in hepatic and 3 in neurological group, 3 of hepatic WD expired and 2 developed neurological manifestations. One patients developed proteinuria while penicillamine treatment .About half of patients with WD were improved. Adequate cupriuresis occurred at three months. All the symptoms and biochemical markers WD improved gradually. No significant side effect was seen. Key words: Wilson's disease; penicillamine; urinary copper. DOI: 10.3329/jdmc.v18i1.6304 J Dhaka Med Coll. 2009; 18(1) : 37-43
Pharmacoeconomics and rational drug therapy
Authors: Khan MD Ismail
Published: October 2010

DOI: 10.3329/jdmc.v18i2.6264J Dhaka Med Coll. 2009; 18(2) : 91-93
Analysis of Risk Factors Associated with Stroke in Young Adults: A Prospective Study
Authors: Hossain MZ , Ahmed SU , Sarder MH , Dasgupta R , Das A , Sarker RN , Azad KAK , Arif SM , Mohammad QD
Published: October 2010

Objective: Stroke in young patients is not common. The purpose of this study was to find out the risk factors of stroke in young adults in Bangladesh and to compare with different other studies. Methods: 85 young adult cases of stroke patients with the age ranging from 14 to 45 years, admitted in different medical units of Dhaka Medical College Hospital from January 2008 to July 2009, were studied. The risk factors for stroke and the distribution of stroke types were analyzed. Results: The specific age group (14-45 years old) included 6% of patients of all ages admitted for stroke. Among 85 patients, cerebral infarction was diagnosed in 52 patients (61%). Intracerebral hemorrhage (without trauma) was diagnosed in 25 patients (29.4%). Subarachnoid hemorrhage was found in 7 young patients (8.24%). The most common risk factors for ischemic stroke were hypertension (57.68%), hypercholesterolemia (38.46%), diabetes (34.61%), smoking (32.69%), premature atherosclerosis (11.54%). Regarding aetiology of cerebral infarction, the majority due to cardiogenic emboli (75%). The use of oral contraceptives, pregnancy, SLE, migraine and moya moya disease were infrequent causes of cerebral infarction. In ischemic stroke, the ratio of cardiogenic emboli & other factors were 3:1. The most common risk factors for hemorrhagic stroke were hypertension (63.63%), hypercholesterolemia (39.39%), diabetes (36.54%) & smoking (33.33%). Conclusion: Hypertension, Diabetes, tobacco smoking, premature atherosclerosis & rheumatic valvular heart disease are growing problems in the developing countries. According to our finding, identification & treatment of hypertension, dyslipidaemia, diabetes & rheumatic valvular heart disease & cessation of smoking are proper measures to prevent morbidity & mortality. Key words: Risk factors; stroke; young adult. DOI: 10.3329/jdmc.v18i2.6265 J Dhaka Med Coll. 2009; 18(2) : 95-99
Mass Psychogenic Illness among Learners at Jaforabad High School, in Hathazari, Chittagong, Bangladesh
Authors: Amin MR , Mahmood S , Rabbi SF , Hossain AA , Sharif HM
Published: October 2010

Objectives: Mass psychogenic illness involves people with real symptoms that are often triggered by misunderstood or false information. We investigated symptoms of sharing among 15 learners at a high school in Hathazari , Chittagong districts of Bangladesh. Methods: In 4th August, 2007, a student of 8th grade of jaforabad high school noticed feverish feeling in his classroom, and soon thereafter he had a headache, nausea, vertigo, tingling sensation of limbs and burning sensation of the body. Within an hour another 14 learner of different grade suffers same symptoms except fever. An investigation was performed by several government agencies. Results: We were unable to find a medical or environmental explanation for the reported illnesses. The persons who reported symptoms came from 10 classrooms scattered throughout the school. The most frequent symptoms were headache, vertigo, nausea, and abdominal pain. Blood and urine specimens of admitted 3 learners showed no evidence of organic illness. A questionnaire administered two days later show that the reported symptoms were significantly associated with female sex, seeing another ill person and knowing that a classmate was ill. Conclusions: This illness, had features of mass psychogenic illness - notably, widespread subjective symptoms thought to be associated with psychosocial impact. Key words: Mass psychogenic illness; learners. DOI: 10.3329/jdmc.v18i2.6267  J Dhaka Med Coll. 2009; 18(2) : 105-111
Ice Pack Test - An Alternate to Prostigmin Test in the Diagnosis of Myasthenia Gravis with Ocular Involvement: A Simple, Noninvassive and Safe Method
Authors: Sharif AQMO , Faruque GM , Anisuddin AIM , Kabir MF , Zafarullah TA
Published: October 2010

Myasthenia gravis (MG) is the most frequent neuromuscular transmission disorder with incidence of 2-20 patients per million1. Its pathophysiology is autoimmune, with acetylcholine receptors (AChR) autoantibodies damaging the post-synaptic fold at the muscle membrane. MG often presents with isolated ocular symptoms, including diplopia and ptosis, at least at the onset. It is often challenging to confirm the diagnosis of MG. The most traditional diagnostic test for myasthenia gravis is the edrophonium / prostigmin test. However, with this test, false-positive results have been reported in other neurologic disorders like amyotrophic lateral sclerosis, botulism and brain tumour. Furthermore, it also carries a risk of serious cardiac adverse reactions. The ice pack test is a very simple, safe and cheap procedure that can be performed by the physician at the bedside. Considering that the pure ocular form of MG is frequently not detected by the traditional tests available, the ice pack test is an attractive diagnostic method. We describe two cases where the ice pack test was done at the bedside for the diagnosis of MG and then performed prostigmin test and reviewed the literature about this test. In conclusion, the ice pack test is an easy, safe, cheap and reliable test to be used at bedside in the MG suspected patients with ptosis. It is safer and can replace the edrophonium/ prostigmin test in MG with ptosis, since the specificity and sensitivity is 100% when compared. Key words: Myasthenia Gravis (MG); prostigmin test; occular manifestation. DOI: 10.3329/jdmc.v18i2.6268 J Dhaka Med Coll. 2009; 18(2) : 112-114
Indication of Caesarean Section Operation in Preterm Pregnancy and Its Outcome  A Study of 100 Cases
Authors: Wazed F , Jahan S , Tanira S
Published: October 2010

A prospective study of 100 cases of preterm pregnancy was done in the Department of Obstetrics & Gynaecology of Dhaka Medical College Hospital and Mitford Hospital, Dhaka from September 2002 to August 2003. The incidence and indications for caesarean section operation were eclampsia 24%, preeclampsia 20%, antepartum haemorrhage (APH) 15%, premature rupture of membrane (PROM) 8%, PROM with chorioamnionitis 4%, preterm labour with previous caesarean section 9%, foetal distress with labour pain 7%, less foetal movement 6%, malpresentation with cord prolapse 3%, multiple pregnancy 2% and diabetes mellitus with polyhydramnios 2%. Emergency caesarean section was done in 98 cases and elective operation in 2 cases. Live birth was 93% and perinatal mortality was 32%. Neonatal morbiditites were prematurity and birth asphyxia. Maternal mortality in preterm caesarean section was 16%.  Key words: Preterm pregnancy; Caesarean section; Indication; Outcome. DOI: 10.3329/jdmc.v18i2.6271 J Dhaka Med Coll. 2009; 18(2) : 124-126
Study on Biochemical Changes in Exfoliative Dermatitis
Authors: Islam S , Islam AKMA , Sultana A , Hossain MZ
Published: October 2010

A study was carried out in the Department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU) for a period of six months from April to September 2007. 50 patients with exfoliative dermatitis were included in the study according to the inclusion and exclusion criteria. Biochemical changes were detected by collection of blood sample and sending it for biochemical studies. The male and female ratio was 3.17:1. The study showed that 24% patients were anaemic, 44% had raised ESR, 28% had lower serum total protein, 40% had decreased serum albumin, 10% had an altered A:G ratio, 8% had raised serum creatinine, 12% had raised blood urea, 12% had raised SGPT, 10% had raised RBS, 16% had showed decreased serum calcium, 18% had hyponatraemia, 12% had hypokalaemia and 6% had hypochloraemia. Key words: Exfoliative dermatitis; biochemical change. DOI: 10.3329/jdmc.v18i2.6272 J Dhaka Med Coll. 2009; 18(2) : 127-131
A comparison of the efficacy of Olopatadine hydrochloride 0.1% ophthalmic solution and Sodium Chromoglycate ophthalmic solution in the treatment of allergic conjunctivitis
Authors: Uddin AIMA , Faruque GM , Sharif AQMO
Published: October 2010

Aim: To find out an effective drug for the treatment of allergic conjunctivitis and to compare the efficacy of Sodium chromoglycate ophthalmic solution and Olopatadine Hydrochloride 0.1% ophthalmic solution in the treatment of allergic conjunctivitis. Materials and methods: This randomized double blinded study was conducted in National Institute of Ophthalmology and Hospital, Sher-E-BangIa Nagar, Dhaka, from January, 2005 to May, 2009. 100 Patients with ocular allergies attending OPD of NIO&H were included. Each of the patient was randomly included in either of the following two groups by simple lottery method; Group A: 50 Patients receiving olopatadine hydrochloride 0.1% eye drops and Group B: 50 Patients receiving sodium chromoglycate 2% eye drops. Itching score, Redness score, Discharge score, Evaluator's score - baseline and after 21 days of treatment with olopatadine and sodium chromoglycate 2% ophthalmic solution were evaluated following Aguilar (2000). For the relieving of symptoms and signs olopatadine was found to be superior over sodium chromoglycate 2% but the difference was not statistically significant. Conclusion: This clinical study concludes that the relieving of symptoms and signs olopatadine was found to be superior over sodium chromoglycate 2% but the difference was not statistically significant. DOI: 10.3329/jdmc.v18i2.6274 J Dhaka Med Coll. 2009; 18(2) : 136-139
Incidence of Hepatitis-B Among Healthcare Professionals due to Medical Waste Handling
Authors: Morshed MG , Howlader MAR , Sardar MH , Uddin MZ , Khan MA
Published: October 2010

The incidence of hepatitis-B among health care workers due to medical waste handling has been a subject of interest. A hospital base survey was done in Chittagong Medical College Hospital (CMCH), Chittagong during the period of April 2009 through June 2009 among health care workers was done to identify the problem. All types of health care workers especially those are very much vulnerable to needle stick puncture like nurses, ward boys, cleaners, laboratory technicians and doctors were included in this study.Total number of respondents was one hundred (sixty eight male and thirty two female). Age of the respondents ranged from 20-60 years with on average age of 24 ± 5.5 years. 62% of health care workers do not aware of hazards of medical waste. Only 38% are aware of infectious medical waste. Among them only 12% learned about the hazards of medical waste from hospital authority. Rest of them is aware of this implication from personal information. All of the health care workers claimed that they have no training on medical waste handling safely. Even they do not take any protective measure. 66% of the health care workers of different service type were punctured at least once or several times. So the puncture rate was counted with special attention. Sixty percent of ward boys, 90% of nurses, 25% of doctors and 80% of laboratory technicians were punctured once or several times within their job duration.These 5% health care workers were HbsAg positive. Among them one ward boy, two nurses, one cleaner and one laboratory technician were infected with hepatitis B virus. All of them had history of needle stick puncture. One HbsAg positive case was excluded from this study because of history of blood transfusion. Waste sharps are considered highly infectious medical waste causing hepatitis B frequently. Key words: Medical waste; occupational risk; hepatitis B. DOI: 10.3329/jdmc.v18i2.6275 J Dhaka Med Coll. 2009; 18(2) : 140-143
Status of Early Mortality in Newly Diagnosed Cases of Acute Promyelocytic Leukaemia (APL) in BSMMU Hospital
Authors: Rahman F , Yunus ABM , Kabir AL , Begum M , Aziz A , Shah S , Rahman F , Rahman MJ
Published: October 2010

Background: Acute promyelocytic leukemia (APL), is now curable in most cases with current treatment strategies. But limited available data suggest that the rate of early mortality is high and long term survival is poor in many developing countries. To improve the survival rate by reducing early mortality, study of the status of early mortality as the main cause of treatment failure for the management of APL as a heamatological emergency appears to have a great significance. Materials and method: Diagnosis of acute promyelocytic leukemia was done from bone marrow morphological study by experienced haematologist. After that cytogenetic study to see chromosomal translocation 15 and 17 and molecular study to see PML-RARá fusion protein was also done. Clinical and laboratory evaluation was done to all of them. Chemotherapy according to IC-APL protocol was given to 30 out of 40 patients. Incidence of early mortality (death within 14 days of diagnosis) was recorded and also categorized according to cause of death. Pattern of supportive cares given to the patients such as management of coagulopathy. ATRA syndrome or sepsis to treat the disease as a medical emergency was also recorded. Result: Selected clinical, laboratory and outcome data of 40 cases of APL who were admitted in Haematology department of BSMMU was surveyed. The median age overall was 32 yrs. The median WBC count at diagnosis was 7.75×109/L and median platelet count 25×109/L. Laboratory evidence of DIC was noted in 37.5% of patients. Death occurred within 14 days of diagnosis (early death) in 10 (25%) cases. Bleeding was the most common cause of early death, then infectious complication and ATRA syndrome. Among 30 patients who got chemotherapy complete remission (CR) was 66.6%. So only 50% of the total study population was able to achieve CR. So due to early mortality, a significant portion of the study population could not receive protocol based treatment. Conclusion: To improve outcome by reducing initial mortality early recognition and treatment of APL is required in specialized institutions, by prompt and aggressive supportive therapy as well as immediate starting of antileukemic agent such as ATRA, arsenic trioxide etc.  Key words: Acute Promyelocytic Leukaemia (APL); mortality. DOI: 10.3329/jdmc.v18i2.6277 J Dhaka Med Coll. 2009; 18(2) : 150-154
Risk Factors of Road Traffic Accidents (RTA) in context of Bangladesh
Authors: Jabbar MA , Islam MZ , Sultana R , Akhter SFU
Published: October 2010

Objective: To explore the risk factors related to road traffic accident in context of Bangladesh. Design: This was a cross sectional type of descriptive study. Settings: The study was conducted at emergency and casualty department of Dhaka Medical College Hospital (DMCH) and Sir Salimullah Medical College (SSMC) & Mitford Hospital, Dhaka respectively. Study Period: The study was conducted from July 2007 to June 2008. Subjects: A total of 400 Road Traffic Accident (RTA) patients attended during data collection period of 3 months at Dhaka Medical College and Sir Salimullah Medical College (SSMC) & Mitford Hospitals were consider as the study population. Result: This study included 400 Road Traffic Accident (RTA) patients. Among them, 23.8% patients due to accidents were related to truck accidents followed by bus (20.3%) and CNG Taxi (11.3%) respectively It has been revealed that frequency of accidents caused by new vehicles and old vehicles were almost equal (36.5%) and 13.5% vehicle were overloaded when accidents happened. Fast speeds of the vehicles (62%) were responsible for accidents. About 31% stated that even with normal speed accident was happened. About 44.8% accidents were caused due to collision with other vehicles as stated by the patients. Majority of the patients (52.8%) stated that drivers were looked healthy, 17.8% drunker and 5.5% looked drowsy when they drove vehicles during accident. Majority (55%) of them drove in wrong side of the road. In 78.3% cases, there was no traffic signal and though available, 39.1% driver did not follow traffic signal. About 25% patients stated that defective road is the factor of causation of accidents. Majority (76.75%) of the patients opined that accident was happened during day time and in sufficient light (66%). Weather was foggy stated by 16% patients. Only 6.75% victims used protective measure during accidents. Conclusion: This study was conducted with a view to explore the risk factors related to road traffic accident. Nevertheless, it is not feasible to draw a concrete conclusion. But on the basis of this study findings, it may be stated that a greater part of Road Traffic Accidents (RTA) can be prevented by specific preventive measures and also taking personal precautions. It is also to be concluded that countywide wide mass scale study should be carried out in this specific emerging field to combat road traffic accidents as a major public health issue. Key words: Road traffic accidents (RTA); Risk Factors. DOI: 10.3329/jdmc.v18i2.6279 J Dhaka Med Coll. 2009; 18(2) : 161-165
Exhaled Nitric Oxide: A New Lung Function Test
Authors: Begum JA , Islam MI , Hossain MZ , Chowdhury RN
Published: October 2010

DOI: 10.3329/jdmc.v18i2.6280 J Dhaka Med Coll. 2009; 18(2) : 166-168
Paid work between age 60 and 70 years in Europe
Authors: Komp Kathrin , Tilburg Theo van , Groenou Marjolein Broese van
Published: October 2010

Over the past years, older persons’ workforce participation has increased and, after years of studying early retirement, the focus has gradually shifted to workforce participation between age 60 and 70 years. Those are the years directly below and above the mandatory retirement age in most of the European countries. We investigate the influence of socio-economic status (SES) on older persons’ workforce participation. Moreover, we study whether the importance of private pensions in a country modifies the effect of SES. Survey data from eleven European countries are analysed in multilevel analyses. Results show that paid work in old age is the domain of persons with high SES. Moreover, a high share of private pensions in a country diminishes the influence of occupational prestige on men’s workforce participation. This suggests that older persons with low SES deserve particular attention in labour market reforms. Additionally, it suggests that pension reforms be monitored concerning their effects on social inequalities.
Gender roles and social policy in an ageing society
Authors: Makita Meiko
Published: October 2010

This article reviews the major underpinnings of the Japanese welfare state in the context of social care from a feminist perspective. In Japan, familycare responsibilities have traditionally been assigned to women; hence, care has long been a women’s issue. However, as the social contract of a male breadwinner and a ’’professional housewife’’ gradually fades out, Japanese women find more opportunities to renegotiate their caring roles. Of course, this social transformation did not occur in isolation, it was influenced by patterns in economic development, state policies and mainly demographic changes. All this has stimulated new state responses in the form of social welfare expansion that arguably aim to relieve women of the burdens of family-care. The issue remains, however, as to whether Japan would be able to recognise that the main structural issues of population ageing do not originate from demographic changes, but from a strict gendered division of labour and gender inequality.
Determination of the Thermodegradation of deoxyArbutin in Aqueous Solution by High Performance Liquid Chromatography
Authors: Yang Chao-Hsun , Chen Yi-Shyan , Lai Jeng-Shiow , Hong Willy W. L. , Lin Chih-Chien
Published: October 2010

Tyrosinase is the key and rate-limiting enzyme responsible for the conversion of tyrosine into melanin. Competitive inhibition of tyrosinase enzymatic activity results in decreased or absent melanin synthesis by melanocytes in human skin. DeoxyArbutin (4-[(tetrahydro-2H-pyran-2-yl)oxy]phenol), a novel skin whitening agent, was synthesized through the removal of hydroxyl groups from the glucose side-chain of arbutin. DeoxyArbutin not only shows greater inhibition of tyrosinase activity but is also safer than hydroquinone and arbutin. Hence, deoxyArbutin is a potential skin whitening agent for cosmetics and depigmenting drugs; however, stability of this compound under some conditions remains a problem. The lack of stability poses developmental and practical difficulties for the use of deoxyArbutin in cosmetics and medicines. Improving the thermostability of deoxyArbutin is an important issue for its development. In this research, we established an analytical procedure to verify the amount of deoxyArbutin in solutions using a high performance liquid chromatographic (HPLC) method. The results indicate that this novel skin whitening agent is a thermolabile compound in aqueous solutions. Additionally, the rate constant for thermodegradation (k) and the half-life (t1/2) of deoxyArbutin were determined and can be used to understand the thermodegradation kinetics of deoxyArbutin. This information can aid in the application of deoxyArbutin for many future uses.
Postfunctionalization of Alkyne-Linked Conjugated Carbazole Polymer by Thermal Addition Reaction of Tetracyanoethylene
Authors: Michinobu Tsuyoshi , Fujita Hiroyuki
Published: October 2010

The postfunctionalization of the main chain alkyne moieties of carbazole containing poly(arylenebutadiynylene)s was attempted by using a high yielding addition reaction between electron rich alkynes and a strong acceptor molecule, tetracyanoethylene (TCNE). After successful postfunctionalization, the polymer band gap decreased due to the intramolecular donor-acceptor interactions. The resulting donor-acceptor alternating polymer showed a very broad charge-transfer band in the visible region as well as redox activities in both anodic and cathodic directions. The optical band gap showed good agreement with the electrochemical band gap. Furthermore, the thermal stability was enhanced after postfunctionalization. These features of the donor-acceptor alternating polymer are expected to be useful for high performance activities in organic solar cell applications.
Marine Antitumor Drugs: Status, Shortfalls and Strategies
Authors: Bhatnagar Ira , Kim Se-Kwon
Published: October 2010

Cancer is considered as one of the deadliest diseases in the medical field. Apart from the preventive therapies, it is important to find a curative measure which holds no loopholes and acts accurately and precisely to curb cancer. Over the past few decades, there have been advances in this field and there are many antitumor compounds available on the market, which are of natural as well as synthetic origin. Marine chemotherapy is well recognized nowadays and profound development has been achieved by researchers to deal with different molecular pathways of tumors. However, the marine environment has been less explored for the production of safe and novel antitumor compounds. The reason is a number of shortfalls in this field. Though ample reviews cover the importance and applications of various anticancerous compounds from marine natural products, in the present review, we have tried to bring the current status of antitumor research based on marine inhibitors of cancer signaling pathways. In addition, focus has been placed on the shortfalls and probable strategies in the arena of marine antitumor drug discovery.
Effects of Different Maturity Stages on Antioxidant Content of Ivorian Gnagnan (Solanum indicum L.) Berries
Authors: N’Dri Denis , Calani Luca , Mazzeo Teresa , Scazzina Francesca , Rinaldi Massimiliano , Del Rio Daniele , Pellegrini Nicoletta , Brighenti Furio
Published: October 2010

Gnagnan (Solanum indicum L.) is a spontaneous plant widely distributed in Ivory Coast. During ripening stages, Solanum indicum L. presents different colours (green, yellow and red) and is reported to contain several albeit poorly characterized antioxidant compounds. This paper describes in detail the antioxidant profile (ascorbic acid, carotenoids and polyphenols), antioxidant capacity (FRAP test and Folin-Ciocalteau assay) and the colour changes of Gnagnan berries at different ripening levels. Ascorbic acid content was similar in green and yellow berries, but significantly lower in red ones. Red berries showed a higher content of carotenoids compared to green and yellow ones. Regarding polyphenols, several phenolic acids and flavonoids were found in all berries. The content of caffeoylquinic acids, caffeic acid, flavonol glycosides and naringenin was higher in red berries, while the content of p-coumaric acid and feruloylquinic acids was similar among the three colours. The FRAP assay increased with the ripening process, whereas total polyphenols were similar among berries. Significant differences were found for the colorimetric indexes among products of different degrees of ripening. The present results show the important role of the ripening stage in increasing the antioxidant content of Gnagnan berries.