bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment Outcomes of Laryngeal and Hypopharyngeal Squamous Cell Carcinomas in a Tertiary Care Center of Nepal
Authors: Sinha Pallavi , Sinha Bimal Kumar , Baskota Dharma Kanta , Neupane Yogesh , Acharya Kunjan
Published: April 2014

DOI: http://dx.doi.org/10.3126/njenthns.v3i2.10154 Nepalese Journal of Head and Neck Surgery Vol.3(2) 2012: 10-11
Clinical and Bacteriological Study of Chronic Suppurative Otitis Media by Anaerobic Culture Methods in a Teaching Hospital
Authors: Kumar Jagdish , Hima Bindu P
Published: April 2014

DOI: http://dx.doi.org/10.3126/njenthns.v3i2.10155 Nepalese Journal of Head and Neck Surgery Vol.3(2) 2012: 12-14
A Screening Picture Speech Identification Test for Nepali Speaking Children
Authors: Khanal Kabi Raj , Dattatreya T , Karna Sureshwar Lal
Published: April 2014

DOI: http://dx.doi.org/10.3126/njenthns.v3i2.10157 Nepalese Journal of Head and Neck Surgery Vol.3(2) 2012: 15-16
An Unusual Presentation of Thyroid Gland Carcinoma: A Case Report
Authors: Shrestha Kundan Kumar , Jha Anil Kumar , Joshi Rupesh Raj , Rijal Anupama Shah , Dhungana Anup , Regmi S , Amatya A
Published: April 2014

DOI: http://dx.doi.org/10.3126/njenthns.v3i2.10158 Nepalese Journal of Head and Neck Surgery Vol.3(2) 2012: 17-18
Unique Foreign Body Chest Diagnosed Incidentally
Authors: Wahid I Fazal , Khan Muhammad Riaz , Khan Adil , Ahmad Iftikhar
Published: April 2014

DOI: http://dx.doi.org/10.3126/njenthns.v3i2.10159 Nepalese Journal of Head and Neck Surgery Vol.3(2) 2012: 19-20
Patients' Perspective on Doctor's Attire
Authors: Shrestha Abha , Shrestha Bikash , Amatya Ram Chaya , Chawla CD
Published: April 2014

DOI: http://dx.doi.org/10.3126/njenthns.v3i2.10161 Nepalese Journal of Head and Neck Surgery Vol.3(2) 2012: 23-25
Endoscopic Management of Fronto-Ethmoidal Sinus Mucocele
Authors: Neupane Yogesh , Basnet Meenakshi , Pradhan Bibhu
Published: April 2014

DOI: http://dx.doi.org/10.3126/njenthns.v3i2.10162 Nepalese Journal of Head and Neck Surgery Vol.3(2) 2012: 26-28
Stell & Maran's Text Book of Head and Neck Surgery and Oncology: Fifth Edition
Authors: Baskota Dharma Kanta
Published: April 2014

DOI: http://dx.doi.org/10.3126/njenthns.v3i2.10164 Nepalese Journal of Head and Neck Surgery Vol.3(2) 2012: 31
Transorbital endoscopic amygdalohippocampectomy: a feasibility investigation
Authors: Chen H. Isaac , Bohman Leif-Erik , Loevner Laurie A. , Lucas Timothy H.
Published: April 2014

Object

Resection of the hippocampus is the standard of care for medically intractable epilepsy in patients with mesial temporal sclerosis. Although temporal craniotomy in this setting is highly successful, the procedure carries certain immutable risks and may be associated with cognitive deficits related to cortical and white matter disruption. Alternative surgical approaches may reduce some of these risks by preserving the lateral temporal lobe. This study examined the feasibility of transorbital endoscopic amygdalohippocampectomy (TEA) as an alternative to open craniotomy in cadaveric specimens.

Methods

TEA dissections were performed in 4 hemispheres from 2 injected cadaveric specimens fixed in alcohol. Quantitative predictions of the limits of exposure based on predissection imaging were compared with intradissection measurements. The extent of resection and angles of exposure during the dissection and on postdissection imaging were recorded. These measurements were validated with MRI studies from 10 epilepsy patients undergoing standard surgical evaluations.

Results

The transorbital approach permitted direct access to the mesial temporal structures through the lateral orbital wall. Up to 97% of the hippocampal formation was resected with no brain retraction and minimal (mean 6.0 ± 1.4 mm) globe displacement. Lateral temporal lobe white matter tracts were preserved.

Conclusions

TEA permits hippocampectomy comparable to standard surgical approaches without disrupting the lateral temporal cortex or white matter. This novel approach is feasible in cadaveric specimens and warrants clinical investigation in carefully selected cases.
Deep brain stimulation for Huntington's disease: long-term results of a prospective open-label study
Authors: Gonzalez Victoria , Cif Laura , Biolsi Brigitte , Garcia-Ptacek Sara , Seychelles Anne , Sanrey Emily , Descours Irene , Coubes Christine , de Moura Ana-Maria Ribeiro , Corlobe Astrid , James Syril , Roujeau Thomas , Coubes Philippe
Published: April 2014

Object

To date, experience of globus pallidus internus (GPi) deep brain stimulation (DBS) in the treatment of Huntington's disease (HD) has been limited to a small number of case reports. The aim of this study was to analyze long-term motor outcome of a cohort of HD patients treated with GPi DBS.

Methods

Seven patients with pharmacologically resistant chorea and functional impairment were included in a prospective open-label study from 2008 to 2011. The main outcome measure was the motor section of the Unified Huntington's Disease Rating Scale. The primary end point was reduction of chorea.

Results

Patients underwent MRI-guided bilateral GPi implantation. The median duration of follow-up was 3 years. A significant reduction of chorea was observed in all patients, with sustained therapeutic effect; the mean improvement on the chorea subscore was 58.34% at the 12-month follow-up visit (p = 0.018) and 59.8% at the 3-year visit (p = 0.040). Bradykinesia and dystonia showed a nonsignificant trend toward progressive worsening related to disease evolution and partly to DBS. The frequency of stimulation was 130 Hz for all patients. DBS-induced bradykinesia was managed by pulse-width reduction or bipolar settings. Levodopa mildly improved bradykinesia in 4 patients. Regular off-stimulation tests confirmed a persistent therapeutic effect of DBS on chorea.

Conclusions

GPi DBS may provide sustained chorea improvement in selected HD patients with pharmacologically resistant chorea, with transient benefit in physical aspects of quality of life before progression of behavioral and cognitive disorders. DBS therapy did not improve dystonia or bradykinesia. Further studies including quality of life measures are needed to evaluate the impact of DBS in the long-term outcome of HD.
Neuroprotective effects of erythropoietin pretreatment in a rodent model of transient middle cerebral artery occlusion
Authors: Ratilal Bernardo Oliveira , Arroja Mariana Moreira Coutinho , Rocha Joao Pedro Fidalgo , Fernandes Adelaide Maria Afonso , Barateiro Andreia Pereira , Brites Dora Maria Tuna Oliveira , Pinto Rui Manuel Amaro , Sepodes Bruno Miguel Nogueira , Mota-Filipe Helder Dias
Published: April 2014

Object

There is an unmet clinical need to develop neuroprotective agents for neurosurgical and endovascular procedures that require transient cerebral artery occlusion. The aim in this study was to explore the effects of a single dose of recombinant human erythropoietin (rhEPO) before middle cerebral artery (MCA) occlusion in a focal cerebral ischemia/reperfusion model.

Methods

Twenty-eight adult male Wistar rats were subjected to right MCA occlusion via the intraluminal thread technique for 60 minutes under continuous cortical perfusion monitoring by laser Doppler flowmetry. Rats were divided into 2 groups: control and treatment. In the treated group, rhEPO (1000 IU/kg intravenously) was administered 10 minutes before the onset of the MCA ischemia. At 24-hour reperfusion, animals were examined for neurological deficits, blood samples were collected, and animals were killed. The following parameters were evaluated: brain infarct volume, ipsilateral hemispheric edema, neuron-specific enolase plasma levels, parenchyma histological features (H & E staining), Fluoro-Jade–positive neurons, p-Akt and total Akt expression by Western blot analysis, and p-Akt–positive nuclei by immunohistochemical investigation.

Results

Infarct volume and Fluoro-Jade staining of degenerating neurons in the infarct area did not vary between groups. The severity of neurological deficit (p < 0.001), amount of brain edema (78% reduction in treatment group, p < 0.001), and neuron-specific enolase plasma levels (p < 0.001) were reduced in the treatment group. Perivascular edema was histologically less marked in the treatment group. No variations in the expression or localization of p-Akt were seen.

Conclusions

Administration of rhEPO before the onset of 60-minute transient MCA ischemia protected the brain from this insult. It is unlikely that rhEPO pretreatment leads to direct neuronal antiapoptotic effects, as supported by the lack of Akt activation, and its benefits are most probably related to an indirect effect on brain edema as a consequence of blood-brain barrier preservation. Although research on EPO derivatives is increasing, rhEPO acts through distinct neuroprotective pathways and its clinical safety profile is well known. Clinically available rhEPO is a potential therapy for prevention of neuronal injury induced by transitory artery occlusion during neurovascular procedures.
Mesenchymal progenitor cells combined with pentosan polysulfate mediating disc regeneration at the time of microdiscectomy: a preliminary study in an ovine model
Authors: Oehme David , Ghosh Peter , Shimmon Susan , Wu Jiehua , McDonald Courtney , Troupis John M. , Goldschlager Tony , Rosenfeld Jeffrey V. , Jenkin Graham
Published: April 2014

Object

Following microdiscectomy, discs generally fail to undergo spontaneous regeneration and patients may experience chronic low-back pain and recurrent disc prolapse. In published studies, formulations of mesenchymal progenitor cells combined with pentosan polysulfate (MPCs+PPS) have been shown to regenerate disc tissue in animal models, suggesting that this approach may provide a useful adjunct to microdiscectomy. The goal of this preclinical laboratory study was to determine if the transplantation of MPCs+PPS, embedded in a gelatin/fibrin scaffold (SCAF), and transplanted into a defect created by microdiscectomy, could promote disc regeneration.

Methods

A standardized microdiscectomy procedure was performed in 18 ovine lumbar discs. The subsequent disc defects were randomized to receive either no treatment (NIL), SCAF only, or the MPC+PPS formulation added to SCAF (MPCs+PPS+SCAF). Necropsies were undertaken 6 months postoperatively and the spines analyzed radiologically (radiography and MRI), biochemically, and histologically.

Results

No adverse events occurred throughout the duration of the study. The MPC+PPS+SCAF group had significantly less reduction in disc height compared with SCAF-only and NIL groups (p < 0.05 and p < 0.01, respectively). Magnetic resonance imaging Pfirrmann scores in the MPC+PPS+SCAF group were significantly lower than those in the SCAF group (p = 0.0213). The chaotropic solvent extractability of proteoglycans from the nucleus pulposus of MPC+PPS+SCAF-treated discs was significantly higher than that from the SCAF-only discs (p = 0.0312), and using gel exclusion chromatography, extracts from MPC+PPS+SCAF-treated discs also contained a higher percentage of proteoglycan aggregates than the extracts from both other groups. Analysis of the histological sections showed that 66% (p > 0.05) of the MPC+PPS+SCAF-treated discs exhibited less degeneration than the NIL or SCAF discs.

Conclusions

These findings demonstrate the capacity of MPCs in combination with PPS, when embedded in a gelatin sponge and sealed with fibrin glue in a microdiscectomy defect, to restore disc height, disc morphology, and nucleus pulposus proteoglycan content.
Myelomeningocele: surgical trends and predictors of outcome in the United States, 1988–2010
Authors: Kshettry Varun R. , Kelly Michael L. , Rosenbaum Benjamin P. , Seicean Andreea , Hwang Lee , Weil Robert J.
Published: April 2014

Object

Myelomeningocele repair is an uncommonly performed surgical procedure. The volume of operations has been decreasing in the past 2 decades, probably as the result of public health initiatives for folate supplementation. Because of the rarity of myelomeningocele, data on patient or hospital factors that may be associated with outcome are scarce. To determine these factors, the authors investigated the trends in myelomeningocele surgical repair in the United States over a 23-year period and examined patient and hospital characteristics that were associated with outcome.

Methods

The Nationwide Inpatient Sample database for 1988–2010 was queried for hospital admissions for myelomeningocele repair. This database reports patient, hospital, and admission characteristics and surgical trends. The authors used univariate and multivariate logistic regression to assess associations between patient and hospital characteristics and in-hospital deaths, nonroutine discharge, long hospital stay, and shunt placement.

Results

There were 4034 hospitalizations for surgical repair of myelomeningocele. The annual volume decreased since 1988 but plateaued in the last 4 years of the study. The percentages of myelomeningocele patients with low income (30.8%) and Medicaid insurance (48.2%) were disproportionately lower than those for the overall live-born population (p < 0.0001). More operations per 10,000 live births were performed for Hispanic patients (3.2) than for white (2.0) or black (1.5) patients (p < 0.0001). Overall, 56.6% of patients required shunt placement during the same hospital stay as for surgical repair; 95.0% of patients were routinely discharged; and the in-hospital mortality rate was 1.4%. Nonwhite race was associated with increased in-hospital risk for death (OR 2.8, 95% CI 1.2–6.3) independent of socioeconomic or insurance status.

Conclusions

Overall, the annual surgical volume of myelomeningocele repairs decreased after public health initiatives were introduced but has more recently plateaued. The most disproportionately represented populations are Hispanic, low-income, and Medicaid patients. Among nonwhite patients, increased risk for in-hospital death may represent a disparity in care or a difference in disease severity.
Promoting Rational Prescribing Among Medical Practitioners
Authors: Khan MI , Ara N
Published: April 2014

DOI: http://dx.doi.org/10.3329/bmj.v40i2.18495Bangladesh Medical Journal 2011 Vol.40(2): 6-7
Response of Reporting Adverse Drug Reactions among Medical Practitioners
Authors: Nahar N , Karim A , Paul PC , Khan TH
Published: April 2014

Adverse drug Reactions (ADRs) is a global problem of major health concern. Spontaneous reporting of ADRs is the cornerstone of pharmacovigilance. However, underreporting is a huge problem due to lack of reporting culture among medical practitioners. This observational descriptive study was done with the aim to find out the response of reporting adverse drug reactions among medical practitioners and to describe pattern of adverse drug reactions during their practice. Self administered ADR reporting form was distributed to one teaching hospital and ten (10) medical practitioners during the period of December 2009 to December 2010. Total 85 report forms were supplied and response rate was 35% (30185). Among 30 reported cases 16 (53%) were due to antimicrobial, agents and other 14 (47%) cases were due to NSA!Ds, anti psychotics, antidiabetic, antithyroidal, antiepileptics, muscle relaxants and anesthetic agents. 15 cases (50%) need hospitalization for AD Rs, 04 (13%) cases suffer > 1 month and one (3%) case was fatal. 20 cases (67%) express hypersensitivity reaction of various grade and rest reports septicemia, fever, palpitation, tachycardia, dryness of mouth, abdominal pain, swelling of limb, heart burn, restlessness, anorexia, apnoea during anesthesia. All reaction is very important and successfully managed by physicians but reporting not done may be due to lack of awareness. So, steps should be taken at different levels to increase the awareness of reporting adverse drug reactions among medical practitioners and we should strengthen pharmacovigilance in our country DOI: http://dx.doi.org/10.3329/bmj.v40i2.18498 Bangladesh Medical Journal 2011 Vol.40(2): 13-18
Evaluation of Prescribing Practices in the Outpatient Departments of a Teaching Hospital
Authors: Paul PC , Pal DR , Rahaman MM , Islam MJ , Siddique AR
Published: April 2014

Irrational use of medicines is widespread throughout the world. Polypharmacy, injudicious use of antimicrobials and unnecessary use of vitamins are commonly observed. In an attempt to observe the prescribing practices in a Teaching Hospital outpatient departments and to sensitize the future prescribers about rational prescribing, 1200 prescriptions were collected and analyzed by 4th year MBBS students using some of the WHO/INRUD core drug prescribing indicators. The average number of drug per prescription was 3.24. Only 0 13% drugs prescribed under generic names. Around 36.83% of prescriptions were prescribed with antimicrobials and 7.08% prescriptions were contained injections. About 48.35 drugs were prescribed from essential list of drugs and vitamins were prescribed in 33.33% prescriptions. The result revealed that there are apparent lacks of prescribing habit among the prescribers even in a teaching hospital. It is suggested that the periodic evaluation of prescribing practices at a health facility would eventually help to promote rational prescribing. Furthermore, participation of 4th year MBBS students in such exercise may enhance the understanding and sensitize them about rational use of medicines in future. DOI: http://dx.doi.org/10.3329/bmj.v40i2.18499 Bangladesh Medical Journal 2011 Vol.40(2): 19-22
A Review Study - Dietary Management of Psoriasis
Authors: Ali CM
Published: April 2014

Psoriasis is a common, chronic, inflammatory scaly rashes associated with T-cell medicated immunological disorder. The cause of psoriasis is unknown but molecular mechanism suggest an immune disorder and the role of genetic and environmental influence. There are activation of T-cells that releases pro-inflammatory cytokines and causes an inflammatory-·reaction in the affected skin. The inflammatory nature of psoriasis itself is associated with an increased cardio-vascular morbidity. Modern trends of diet consisting high amounts of omega-6 fatty acid and low amounts of omega-3 fatty acid which is associated with a pro-inflammatory state. Dietary modification in the treatment of psoriasis may reduce the need of aggressive approaches and improves the cardio-vascular risk f actors associated with psoriasis. This review summarizes the understanding of dietary modification in the management of psoriasis and to achieve a pathogenesis directed dietary approach in the treatment of psoriasis. DOI: http://dx.doi.org/10.3329/bmj.v40i2.18500 Bangladesh Medical Journal 2011 Vol.40(2): 23-25
The Role of Combination of 20% Azelaic Acid with 0.05% Tretinoin Cream in the Treatment of Melasma
Authors: Hazra SC , Siddique MR , Khondker L , Khan MSI , Mahmud MM
Published: April 2014

Melasma is characterized by brown patches, typically on malar prominences and forehead. The pigmented patches are usually affect darker complexioned individual especially Asian. So it is a great problem in our country. A clinical trial was conducted to find out the effect of the combination of 20% azelaic acid cream with 0.05% tretinoin cream in the treatment of melasma. Thirty clinically diagnosed cases of melasma attending the outpatient department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, were enrolled Majority of !he study subjects (43%) were between 26 to 30 years and most of them (73.3%) were female. Regarding occupation 56.7% were housewife. Out of the study subjects 70% were married and 86.7% were of middle class. Around 66.7% cases had positive family history of melasma and maximum 93.3% patient had no history of systemic drug and the maxim11m 73.3% patient had no history of use of cosmetics. It was observed that highest (93.3%) number of patients had malar area involvement and 6. 7% had centro-facial area involvement. The st11dy showed that after treatment, the average MASI (Melasma Area and Severity Index) score was decreased by 38 66% indicating moderate reduction of the severity of melasma Out of the study subjects, 50%, 30%, 16% developed burning sensation, itching and erythema respectively It could be concluded that combination of 20% azelaic acid and 0.05% tretinoin cream, has a moderate lightening effect in the treatment of melasma. DOI: http://dx.doi.org/10.3329/bmj.v40i2.18501 Bangladesh Medical Journal 2011 Vol.40(2): 26-30
Demographic Variables and Histological Scoring of Non-Alcoholic Fatty Liver Disease in a Bangladeshi Population
Authors: Majid N , Rahman MR , Rajib RC , Shermin S , Ahmad F , Akond AK
Published: April 2014

A cross sectional study was carried out in the Department of Pathology, Dhaka Medical College, Dhaka and Department of hepatology, Bangabandhu Sheikh Mujib Medical University (BSMMU) during the period of July 2007 to June 2009. Total 55 adult subjects of both sexes were included in this study to evaluate the histological pallern of nonalcoholic fatty liver disease (NAFLD) and its relation with demographic variables including age, sex, BMI, obesity and waist circumference. NAFLD is characterized by macrovesicular deposition of fat in liver. It is now days recognized as a major cause of liver disease and has the propensity for progression to fibrosis and cirrhosis. Study subjects with bright echogenic liver on ultrasonography with no history of alcohol consumption and without having hepatitis B and hepatitis C infections were included. All of them undergone liver biopsy and H&E and Masson's Trichrome stain slides were examined to evaluate the grade and stage of lVAFLD. Scoring and semiquantitative assessment of steatosis and NAFLD severity was done according to Kleiner scale known as NAFLD Activity Score (NAS). Among the subjects 24 were male and 31 female. Mean age 41±10. 66 years (range 20 - 65 years), BMI 29.13±3. 79 kg/m2 (range 24.22 - 39.00 kg/m2), mean of male waist circumference 92.03±6.75 cm (range 88-109 cm) and mean of female waist circumference was 90.17±6.6cm (range 80-102 cm). Only BMI correlated significantly with NAS score whereas age, BMI and waist circumference of male and female subjects correlated significantly with stage of fibrosis. The study concludes that in developing countries like Bangladesh the incidental finding of NAFLD is increasing because of change in life style and food habit. DOI: http://dx.doi.org/10.3329/bmj.v40i2.18508 Bangladesh Medical Journal 2011 Vol.40(2): 36-40
A study of Correlation Between motor Component of GCS score on Admission and Glasgow Outcome scale Score at Discharge in head injured Patients who underwent Surgical intervention
Authors: Saha AK , Khan AH , Islam KMT , Hossain M , Sarker AC , Khair A , Burua KK
Published: April 2014

The aim of this study was to establish a correlation between the motor component of Glasgow Coma Scale (GCS) score on admission and Glasgow outcome scale (GCS) score at discharge (on 10th post-operative day) who underwent surgical intervention in head injured patients. This cross sectional study was carried out at the department of neurosurgery, BSMMU from November; 2005 to May, 2007 on head injured patients who underwent surgical intervention. A total of (35 patients with their age ranged from 5 yrs to 50 yrs who came within 3 days after head injury were included in this study. The patients were examined and the motor component of GCS score on admission and GOS at discharge (on 10th postoperative day) were recorded. Data were collected with the help of a structured questionnaire and face-to-face interview with the attendants of the patients. All relevant data were compiled manually in a master data sheet and then organized by scientific calculator. Best motor response and GOS score exhibit a linear relationship (r = 0.372, p = 0.028) indicating that higher the best motor response on admission higher is the GOS score at discharge (on 10th post-operative day). DOI: http://dx.doi.org/10.3329/bmj.v40i2.18509 Bangladesh Medical Journal 2011 Vol.40(2): 41-46
A Study on Different Laboratory Methods for Diagnosis of Intestinal Protozoal Infections
Authors: Shahid SB , Wazib A , Chowdhury A , Shamsuzzaman SM , Mamun KZ
Published: April 2014

This cross sectional study was done from January 2009 to June 2010 in Microbiology department of Dhaka Medical College, Dhaka on different laboratory methods for diagnosis of intestinal protozoal infections and their distribution among selected study population. Of the 375 stool samples evaluated, 103 (27.5%) samples were positive for the intestinal protozoa. The prevalence of G. intestinalis was highest (25.78%) followed by E. histolytica/dispar (8.98%). Other protozoa found were, E. coli (1.56%), B. hominis (1.95%), C. mesnilli (1.17%) and C. parvum (0. 78%). lron-hematoxyline stain showed highest sensitivity for detection of protozoa. DOI: http://dx.doi.org/10.3329/bmj.v40i2.18510 Bangladesh Medical Journal 2011 Vol.40(2): 47-49
Growth and Developmental Status of Children with Congenital Heart Disease
Authors: Nasiruzzaman AHm , Hussain MZ , Baki MA , Tayeb MA , Mollah MN
Published: April 2014

Cardiac malformations ore responsible for malnutrition, which may range from mild under nutrition to severe failure to thrive (FTT). Developmental delay was also associated with congenital heart disease. The aim of the study was to evaluate the nutritional status and developmental status of children with congenital heart disease. This cross sectional study was done in the department of Paediatrics, BSMMU and Dhaka Shishu Hospital from March'08 to February'09. Children, age 1 month to 6 years with congenital heart disease confirmed by echocardiogram (both cyanotic and acyanotic heart disease) were included in this study. Total 50 children included in this study. Mean age of study patient was 3.04 (±2.01SD) years. Ventricular septal defects were found as leading number (36%). Tetralogy of Fallot was found in 26% cases. According to WHO standard 38% children from acyanotic and 16%/rom cyanotic heart disease were severely stunted. Ten percent children from acyanotic and 04% from cyanotic heart disease were severely wasted. Gross motor and fine motor delay was present in 60% and 54% of children. Forty four percent children had speech delay and social impairment was present in 32% children. Severe stunting was more common than wasting in this study. Gross motor and fine motor delay was found the main developmental problem. DOI: http://dx.doi.org/10.3329/bmj.v40i2.18512 Bangladesh Medical Journal 2011 Vol.40(2): 54-57
Hydatid Cyst in the Uterus of Young Lady
Authors: Yousuf NA , Chowdhury MAK , Ahmed SU
Published: April 2014

Echinococcal disease remains a problem within some endemic areas. Echinococcal cysts usually involve the liver and lungs, but are extremely rare in the uterus. In this paper we report the rare case of a 27-year-old unmarried doctor presented with the complains of menorrhagia for 9 months and lump in lower abdomen for 6 months. Ultrasonography and MRI revealed a large multiloculated cystic lesion within the uterine cavity. Serological tests were positive for echinococcus. The patient was operated on; cysts were removed from uterine cavity. Antihelminthics were administered postoperatively and the patient was closely followed up for 9 months, without menorrhagia or recurrence of Echinococcal cyst. Although Echinococcal cysts are extremely rare in the uterus, it can be managed successfully. DOI: http://dx.doi.org/10.3329/bmj.v40i2.18513 Bangladesh Medical Journal 2011 Vol.40(2): 58-60
Diagnosis of Testicular Choriocarcinoma: A Case Study
Authors: Arif NUM , Shaikh AU , Ranen B , Waheed Z
Published: April 2014

Testicular cancer, although relatively rare, is the most common malignancy in men at the age of 15 to 35 years. Germ cell tumor (GCT) is the most common testicular tumor (90%-95%) and peak age of incidence is between 20 years to 50 years. Choriocarcinoma is very rare in male as a pure testicular tumor (<1%) but may be seen as a component of mixed GCT. These tumors characteristically secrete hCG (human chorionic gonadotrophin) into the serum, which use as an important serum tumor marker for these tumors. A 30 years old male presented to us with the complaints of hard feeling of the left testis for 6 months which was initiated with mild pain but the size of the testis was unchanged. On examination there was an indurated area (2cm X 2cm) at lower part of the left testis and epididymis felt separately. He had no history crypto-orchidism, orchitis and scrotal trauma. Ultrasonogram showed a mixed echoic mass lesion (13 X 10mm) at infero-medial aspect left testis with an epididymal cyst. On laboratory investigation his ?-hCG and AFP level were 306 MIU/L(high) & 6.3 IU/L respectively. Contrast enhanced CT scan of the whole abdomen revealed no abnormality except enlarged lymph node (> 1 CM) in right lower lung. Fine needle aspiration cytology (FNAC) showed features of chronic orchitis. We explored his left testis because of high ?-hCG through inguinal approach and suspected testicular tissue was sent for frozen section biopsy which also revealed inconclusive findings. On the basis of his high ?-hCG, we performed left radical orchidectomy. Histopathology of the left testis showed features of Choriocarcinoma, epididymis and spermatic cord were normal. According to TNM classification, AJCC (American Joint Committee on Cancer) staging and international germ cell consensus prognostic classification it was T3N0MISI, stage IIIa and intermediate prognosis group respectively. Postorchidectomy ?-hCG dropped to 7.3 MIU/ML. Now he is on systemic chemotherapy BEP(bleomycin, etoposide, cisplatin). Choriocarcinoma, though is a rare malignancy, it may affect young men in the prime of life and is the most aggressive histologic variant of germ cell tumor. But it has a good prognosis if diagnosed early and treated accurately. Serum ?-hCG level plays most important role in diagnosis, in monitoring therapy and follow-up of patients with choriocarcinoma. DOI: http://dx.doi.org/10.3329/bmj.v40i2.18514 Bangladesh Medical Journal 2011 Vol.40(2): 60-62
Reconstruction of Angle of the Mouth by Microvascular Radial Forearm Free flap- A case report
Authors: Litu MA , Chowdhury NK , Rahman M , Hassan S , Alam ABM Korshed , Alam Z
Published: April 2014

The terms free flap and free tissue transfer are synonymous used to describe the movement of tissue from one site on the body to another. "Free" implies that the tissue, along with its blood supply, is detached from the original location (donor site) and then transferred to another location (recipient site). However, studies are still going on about the different aspects of its success and failure. The present case report is one such step to share our experience. In this case report successful microvascular free tissue transfer was possible With the increase in experience we can expect increased success rate as well. DOI: http://dx.doi.org/10.3329/bmj.v40i2.18515 Bangladesh Medical Journal 2011 Vol.40(2): 62-64
Measure for Measure: Prophetic History, Qur'anic Exegesis, and Anti-Sunnī Polemic in a Fāṭimid Propaganda Work (BL Or. 8419)
Authors: Pregill Michael
Published: April 2014

The acephalous British Library manuscript Or. 8419 is currently catalogued as a qiṣaṣ al-anbiyāʾ or compilation of Islamic narratives about the prophets. However, an examination of its contents reveals that although it does focus on the various prophets – including Muḥammad himself – and their missions, the text is more accurately characterised as Ismāʿīlī taʾwīl, a commentary on Qur'anic passages that draws parallels between the struggles of the prophets of the past and the persecution of the Shīʿa in the present. The central argument of the text is that while the Shīʿī Imāms and their supporters continue the legacy of the prophets and their virtuous followers in the past, the majority of the Muslim community has gone astray just as the Jews and Christians did before them, especially in their denial of the claims of the ahl al-bayt. Various indications in the text suggest that it was produced as propaganda supporting the claims of the Fāṭimids at an early juncture in the dynasty's history, possibly during the reign of the first caliph-Imām, al-Mahdī.
The Qur'an and Epic
Authors: Lawson Todd
Published: April 2014

While the textual flow of the Qur'an is notoriously challenging and complex, it is also the case that in the process of reading or listening the centre of narrative gravity is never lost. This powerful focus may be termed the epic journey, a struggle from a state of barbarousness to one of civilisation, from ignorance to enlightenment. The hero of this ‘epic’ is, of course, the prophet or messenger, for whom history, as told in the Qur'an, provides many examples. In this paper we will examine basic, sometimes disputed, features of the epic as they may be recognised in a series of such works (for example, The Odyssey, ‘Gilgamesh’, The Shah-nameh, The Divine Comedy, and Paradise Lost). Such reflection is useful for scholarship in a world where the Qur'an is so obviously a part of the shared, if not always recognised, literary heritage of humanity. Among the subsidiary themes to be tested against the notion of ‘epic’ are: humanity, community, apocalypse, and the path or road. In addition to such thematic questions, other compositional and stylistic features of the epic will be studied: orality, rhetoric, figure, metonymy, metre, rhyme, and voice. Finally, the question of audience and performance will be broached to further delineate similarities and differences amongst various theories of the epic, as they can or cannot be applied to the Qur'an.
Carrying Living Water for the Healing of God's People: Women Leaders in the Fifohazana Revival and the Reformed Church in Madagascar
Authors: Sigg Michèle Miller
Published: April 2014

For over one hundred years the Fifohazana Revival has played a key role in the spread of Christianity in Madagascar. The Fifohazana is an indigenous Christian movement that seeks to serve Malagasy society through the preaching of the Gospel and a holistic ministry of healing in community.

This article summarises the findings of a study that explored the role of women leaders as holistic healers in the Fifohazana revival movement and the Reformed Church (FJKM) in Madagascar. Based on interviews with four women ministering in the Fifohazana or the Reformed Church, including a rising leader in the revival movement, this study highlights the importance of women leaders as radical disciples and subversive apostles in the Fifohazana revival movement and in the Reformed Church. As such, these women have been instrumental in bringing renewal into the church through the work of the Holy Spirit in the holistic healing ministry of the Fifohazana.
Mizo Beliefs and the Christian Gospel: Their Interaction with Reference to the Concepts of Health and Healing
Authors: Behera Marina Ngursangzeli
Published: April 2014

The Mizos of northeast India have their own unique culture and society with indigenous religious beliefs that were closely linked with their everyday needs and their world-views. For the Mizos the world was inhabited by spirits, some benevolent and some evil. The evil spirits were believed to cause all kinds of illnesses and misfortunes, and in order to recover from such illnesses the evil spirits had to be placated by sacrifices known as inthawina which can be understood as ‘ceremonial cures’. The Mizos lived in fear, always afraid of evil spirits, and their religious energies were centred on propitiating these evil spirits through frequent sacrifices. The Puithiams (priests) would officiate at such events. Christianity brought inevitable change in the Mizos' religious and world-views. Nevertheless, many of the existing pre-Christian beliefs of Mizo society were adopted or modified by missionaries to help the Mizos to understand more fully Christian concepts and beliefs, especially with reference to the concepts of health and healing. It can also be argued that pre-Christian social, religious and cultural beliefs carried in them ‘theologies of life’ which were adopted by missionaries or those spreading the gospel message, thus allowing these practices, as well as Christian doctrines themselves, to be seen in a new light.
Faster and Simpler Approximation of Stable Matchings
Authors: Paluch Katarzyna
Published: April 2014

We give a 3 2 -approximation algorithm for finding stable matchings that runs in O(m) time. The previous most well-known algorithm, by McDermid, has the same approximation ratio but runs in O(n3/2m) time, where n denotes the number of people andm is the total length of the preference lists in a given instance. In addition, the algorithm and the analysis are much simpler. We also give the extension of the algorithm for computing stable many-to-many matchings.
Potential of Biological Processes to Eliminate Antibiotics in Livestock Manure: An Overview
Authors: Massé Daniel , Saady Noori , Gilbert Yan
Published: April 2014

Degrading antibiotics discharged in the livestock manure in a well-controlled bioprocess contributes to a more sustainable and environment-friendly livestock breeding. Although most antibiotics remain stable during manure storage, anaerobic digestion can degrade and remove them to various extents depending on the concentration and class of antibiotic, bioreactor operating conditions, type of feedstock and inoculum sources. Generally, antibiotics are degraded during composting > anaerobic digestion > manure storage > soil. Manure matrix variation influences extraction, quantification, and degradation of antibiotics, but it has not been well investigated. Fractioning of manure-laden antibiotics into liquid and solid phases and its effects on their anaerobic degradation and the contribution of abiotic (physical and chemical) versus biotic degradation mechanisms need to be quantified for various manures, antibiotics types, reactor designs and temperature of operations. More research is required to determine the kinetics of antibiotics’ metabolites degradation during anaerobic digestion. Further investigations are required to assess the degradation of antibiotics during psychrophilic anaerobic digestion.
A Multi-Year Aerosol Characterization for the Greater Tehran Area Using Satellite, Surface, and Modeling Data
Authors: Crosbie Ewan , Sorooshian Armin , Monfared Negar , Shingler Taylor , Esmaili Omid
Published: April 2014

This study reports a multi-year (2000–2009) aerosol characterization for metropolitan Tehran and surrounding areas using multiple datasets (Moderate Resolution Imaging Spectroradiometer (MODIS), Multi-angle Imaging Spectroradiometer (MISR), Total Ozone Mapping Spectrometer (TOMS), Goddard Ozone Chemistry Aerosol Radiation and Transport (GOCART), and surface and upper air data from local stations). Monthly trends in aerosol characteristics are examined in the context of the local meteorology, regional and local emission sources, and air mass back-trajectory data. Dust strongly affects the region during the late spring and summer months (May–August) when aerosol optical depth (AOD) is at its peak and precipitation accumulation is at a minimum. In addition, the peak AOD that occurs in July is further enhanced by a substantial number of seasonal wildfires in upwind regions. Conversely, AOD is at a minimum during winter; however, reduced mixing heights and a stagnant lower atmosphere trap local aerosol emissions near the surface and lead to significant reductions in visibility within Tehran. The unique meteorology and topographic setting makes wintertime visibility and surface aerosol concentrations particularly sensitive to local anthropogenic sources and is evident in the noteworthy improvement in visibility observed on weekends. Scavenging of aerosol due to precipitation is evident during the winter when a consistent increase in surface visibility and concurrent decrease in AOD is observed in the days after rain compared with the days immediately before rain.
Neutrophil Gelatinase-Associated Lipocalin (NGAL), Pro-Matrix Metalloproteinase-9 (pro-MMP-9) and Their Complex Pro-MMP-9/NGAL in Leukaemias
Authors: Bouchet Sandrine , Bauvois Brigitte
Published: April 2014

Matrix metalloproteinase (MMP)-9 and neutrophil gelatinase-associated lipocalin (NGAL) have gained attention as cancer biomarkers. The inactive zymogen form of MMP-9 (pro-MMP-9) also exists as a disulphide-linked heterodimer bound to NGAL in humans. Leukaemias represent a heterogeneous group of neoplasms, which vary in their clinical behavior and pathophysiology. In this review, we summarize the current literature on the expression profiles of pro-MMP-9 and NGAL as prognostic factors in leukaemias. We also report the expression of the pro-MMP-9/NGAL complex in these diseases. We discuss the roles of (pro)-MMP-9 (active and latent forms) and NGAL in tumour development, and evaluate the mechanisms by which pro-MMP-9/NGAL may influence the actions of (pro)-MMP-9 and NGAL in cancer. Emerging knowledge about the coexpression and the biology of (pro)-MMP-9, NGAL and their complex in cancer including leukaemia may improve treatment outcomes.
Inflammatory and Bone Remodeling Responses to the Cytolethal Distending Toxins
Authors: Belibasakis Georgios , Bostanci Nagihan
Published: April 2014

The cytolethal distending toxins (CDTs) are a family of exotoxins produced by a wide range of Gram-negative bacteria. They are known for causing genotoxic stress to the cell, resulting in growth arrest and eventually apoptotic cell death. Nevertheless, there is evidence that CDTs can also perturb the innate immune responses, by regulating inflammatory cytokine production and molecular mediators of bone remodeling in various cell types. These cellular and molecular events may in turn have an effect in enhancing local inflammation in diseases where CDT-producing bacteria are involved, such as Aggregatibacter actinomycetemcomitans, Haemophilus ducreyi, Campylobacter jejuni and Helicobacter hepaticus. One special example is the induction of pathological bone destruction in periodontitis. The opportunistic oral pathogen Aggregatibatcer actinoycemetemcomitans, which is involved in the aggressive form of the disease, can regulate the molecular mechanisms of bone remodeling in a manner that favors bone resorption, with the potential involvement of its CDT. The present review provides an overview of all known to-date inflammatory or bone remodeling responses of CDTs produced by various bacterial species, and discusses their potential contribution to the pathogenesis of the associated diseases.
Assessment of the Genetic Diversity in Forest Tree Populations Using Molecular Markers
Authors: Porth Ilga , El-Kassaby Yousry
Published: April 2014

Molecular markers have proven to be invaluable tools for assessing plants’ genetic resources by improving our understanding with regards to the distribution and the extent of genetic variation within and among species. Recently developed marker technologies allow the uncovering of the extent of the genetic variation in an unprecedented way through increased coverage of the genome. Markers have diverse applications in plant sciences, but certain marker types, due to their inherent characteristics, have also shown their limitations. A combination of diverse marker types is usually recommended to provide an accurate assessment of the extent of intra- and inter-population genetic diversity of naturally distributed plant species on which proper conservation directives for species that are at risk of decline can be issued. Here, specifically, natural populations of forest trees are reviewed by summarizing published reports in terms of the status of genetic variation in the pure species. In general, for outbred forest tree species, the genetic diversity within populations is larger than among populations of the same species, indicative of a negligible local spatial structure. Additionally, as is the case for plants in general, the diversity at the phenotypic level is also much larger than at the marker level, as selectively neutral markers are commonly used to capture the extent of genetic variation. However, more and more, nucleotide diversity within candidate genes underlying adaptive traits are studied for signatures of selection at single sites. This adaptive genetic diversity constitutes important potential for future forest management and conservation purposes.
SEM Evaluation of Internal Adaptation of Bases and Liners under Composite Restorations
Authors: Dionysopoulos Dimitrios , Koliniotou-Koumpia Eugenia
Published: April 2014

The aim of this study was to evaluate the interfacial microgaps generating between different materials and between materials and dentin after polymerization of the composite restorations, using SEM. Methods: The materials investigated were a composite, an adhesive, a RMGI, and a calcium hydroxide. Thirty third molars were selected and two circular class V cavities (5 mm × 3 mm) for each tooth were made. The teeth were randomly assigned into six groups and restored with a combination of the materials. The specimens were subjected to thermocycling and each tooth was sectioned mesiodistally in two halves. Each half was sectioned along the longitudinal axis through the center of the restorations to obtain a slice of 2 mm. The specimens were examined under SEM. The interfaces between the liners, the liners and dentin, and between the liners and the composite were examined for microgaps. Results: The results showed that there was not any significant difference in the mean width of microgaps in the interfaces between Dycal-dentin and Vitrebond-dentin (p>0.05). However, the width of microgaps in the interfaces between dentin-Clearfil Tri-S Bond was significantly smaller (p<0.05). The use of Clearfil Tri-S Bond reduced the possibility of microgap formation between the bonded interface and the materials tested.
Carbon Stocks and Climate Change: Management Implications in Northern Arizona Ponderosa Pine Forests
Authors: Bagdon Benjamin , Huang Ching-Hsun
Published: April 2014

Researchers have observed climate-driven shifts of forest types to higher elevations in the Southwestern US and predict further migration coupled with large-scale mortality events proportional to increases in radiative forcing. Range contractions of forests are likely to impact the total carbon stored within a stand. This study examines the dynamics of Pinus ponderosa stands under three climate change scenarios in Northern Arizona using the Climate Forest Vegetation Simulator (Climate-FVS) model to project changes in carbon pools. A sample of 90 stands were grouped according to three elevational ranges; low- (1951 to 2194 m), mid- (2194 to 2499 m), and high- (2499 to 2682 m.) elevation stands. Growth, mortality, and carbon stores were simulated in the Climate-FVS over a 100 year timespan. We further simulated three management scenarios for each elevational gradient and climate scenario. Management included (1) a no-management scenario, (2) an intensive-management scenario characterized by thinning from below to a residual basal area (BA) of 18 m2/ha in conjunction with a prescribed burn every 10 years, and (3) a moderate-management scenario characterized by a thin-from-below treatment to a residual BA of 28 m2/ha coupled with a prescribed burn every 20 years. Results indicate that any increase in aridity due to climate change will produce substantial mortality throughout the elevational range of ponderosa pine stands, with lower elevation stands projected to experience the most devastating effects. Management was only effective for the intensive-management scenario; stands receiving this treatment schedule maintained moderately consistent levels of basal area and demonstrated a higher level of resilience to climate change relative to the two other management scenarios. The results of this study indicate that management can improve resiliency to climate change, however, resource managers may need to employ more intensive thinning treatments than currently proposed to achieve the best results.