The present study comprised of 20 eyes of 14 patients with keratoconus presenting at a single centre. The study was conducted to compare the uncorrected visual acuity (UCVA) in patients before and after Corneal Collagen Crosslinking with Riboflavin (C3R). Follow- up period was 6 months. A comprehensive systemic and ocular history was taken and a through slit lamp examination, UCVA, refraction, fundus, intraocular pressure, pachymetry and corneal topography was done. Corneal collagen crosslinking was performed and UCVA was checked at 1 month, 3 months and 6 months. Statistical analysis was performed and it was noted that the mean UCVA improved statistically as compared to the preoperative value. Hence, UCVA is likely to improve in patients who undergo C3R.

The current study evaluated the sedative and anxiolytic activity of methanol extract of Nerium oleander (Family: Apocynaceae) leaves alongside with its phytochemical screening. Preliminary phytochemical screening revealed the presence of reducing sugar, tannin, glycoside, flavonoids, alkaloids, gum and protien. The methanol extract of Nerium oleander (MENO) was evaluated for sedative activity using the mice model open field test and hole cross test. The effect of MENO on central nervous system (CNS) for anxiolytic activity was determined by light/dark Box, elevated plus maze test and whole board test using swiss albino mice as experimental animal. The MENO showed significant (p<0.05) sedative effect at the doses of 200 and 400 mg/kg body weight in Open field test and Hole cross test. The present study demonstrated that MENO showed significant (p<0.05) anxiolytic effect at the doses of 200 and 400 mg/kg body weight in light-dark box test and elevated plus maze test. The movement of mice decreased significantly in hole-board test after the administration of MENO at doses of 200 and 400 mg/kg body weight, which indicates the potential anxiolytic activity. The present study indicates that the MENO possesses sedative and anxiolytic activity which trend to justify its use as traditional medicine. So, the plant may be further subjected to chemical investigation to isolate and purify the bioactive compound(s) responsible for its pharmacological activity.

There is at present no comprehensive consensus on methodology and data collection for ABR surveillance. Schedule surveillance in most countries is often based on samples taken from patients with severe infections– particularly infections associated with health care, and those in which first-line treatment has failed. Community-acquired infections are almost positively under represented among samples, leading to gaps in coverage of important patient groups. Increasing incomes and a growing population are driving an increased demand for animal products in India, as is the case in other low and middle-income countries. Food animals are measured as key reservoirs of antibiotic-resistant bacteria with the use of antibiotics in the food production industry having contributed to the actual global challenge of ABR. In the modern era the utilization of dietary chicken is gradually increasing in India because more chicken is being consumed by the non-vegetarian populations. The recommended levels of AMAs in feed were 5- 10g/kg in 1950's and have since increased 10-20 times. The present case study is conducted in Dehradun region of Uttrakhand state of India to evaluate and assess the antibiotics mistreatment in the population. Center for Science and Environment (CSE) report indicating antibiotic residues in poultry is considered as ground motive to analyze the locality and record their antibiotic uses outcomes. The present surveillance based on the questionnaire survey; participants were interviewed with open and closed-ended questions. A total 100 individuals were involved in the study. 60% of the patients consult a doctor before starting antibiotics whereas 40% of the patients accepted that they do not consult a doctor before starting antibiotics. The recent history to suffer from a viral disease was positive in 60%. Consequently, it is accomplished that non-vegetarians are at great risk of developing antibiotic resistant due to irrational use of antibiotics among poultry along with adverse drug reaction of ADRs. The development & progression of Antibiotic resistant in Indian patients is influenced by their socioeconomic class.

Kalamegha (Andrographis paniculata) is a medicinal plant conventionally used for the treatment of anti-inflammatory, antioxidant, antibacterial, antiparasitic, antispasmodic, antidiabatic, anti carcinogenic, Hepatoprotective ,antipyretic, antidiarrhoeal, nematocidal, anti-HIV and numerous infectious diseases ranging from malaria to dysentery. The plant is extensively used in ayurvedic and homeopathic systems of medicines. The drugs are said to be lord of all plants, as it conquers number of diseases. In Samhita and Chikitsa grantha, Kiratatikta and Kalamegha drugs are very frequently indicated in diseases like Daah, Kasa, Jawaragan, Swans, Udar. In the present work an attempt has been made to emphasize the folk herbal medicine which will aid in the identification of fresh as well as dried crude sample of leaves anatomically and Pharmacognostical. The study deals with macroscopic, microscopic, phytochemical analysis and TLC fingerprinting. These studied will provide referentially information for correct identification and for standardization.

Epigenetic silencing of tumor suppressor genes (TSG) is a fundamental incident in the pathogenesis of human cancer. Inactivation of TSG is accomplished by aberrant chromatin modifications including DNA hypermethylation of the gene promoter. Of the most frequently hypermethylated TSG, Ras Association Domain Family1 (RASSF1A), P16 and Death Association Protein kinase (DAPK) genes. Aberrant hypermethylation of these genes have been correlated with non small cell lung cancer (NSCLC) promoting disease recurrence and remote metastasis. This review aims to provide the readers with a precise description of the research to date in the field of epigenetics and its impact on people with NSCLCs. The focus of this study will be on promoter hypermethylation of three different lung cancer associated genes P16, RASSF1A and DAPK and how these genes inactivated and contribute to the pathogenecity of human malignancies. Moreover, The study aims to investigate the impact of tobacco smoke on the hypermethylation frequency of the mentioned genes. Thus, the promoter hypermethylation frequency could be a promising biomarker to improve NSCLC diagnosis and screening.

Background: Head and neck cancers (HNCs) account for 30% of all cancers in Bangladesh. In Bangladesh, tobacco related cancers are very common because of the widespread use of tobacco. The paucity of any study from this region in young head and neck patients has prompted us to take up this study. Objective: To find out the head and neck squamous cell carcinoma in young adults patients. Methodology: A retrospective study was conducted at Oncology Department, Enam Medical College & Hospital, and Dhaka, Bangladesh during January 2019 to December 2019. Data regarding tumor site, age, sex, education, habit of tobacco (smokeless and smoke), and betel nut consumption were analyzed using IBM SPSS version 19. P<0.05 was considered as statistically significant. Results: About 75.1% patients were males. Among patients ≤39 years, 83.7% were tobacco chewers, 50.5% were smokers, and 83.7% betel nut chewers, and among >39 years, these proportions were 83.7%, 56.2%, and 78.7%, respectively. The most common site among ≤39 years and >39 were mouth (40.8%) and hypopharynx (36.8%). Among tobacco and betel nut chewers and smokers, the most common sites were mouth (40.3%, 42.5%) and hypopharynx (41.5%). The site of head and neck squamous cell carcinoma was highly associated with chewing and smoking habit (P<0.05). Among illiterate patients, proportions of tobacco and betel nut chewers and smokers were 65.3%, 61.6%, and 67.9%, respectively. Conclusion: A positive association between tobacco use, male gender, and low education levels were found. The younger generation should be made aware about the adverse health consequences of tobacco use to reduce the preventable risk factors of HNC.

Malakoplakia has been rarely reported in renal transplant recipients. We discuss two renal transplant recipients with malakoplakia involving renal allografts. Both transplant recipients were managed with reducing the doses of immunosuppressive medications and long-term oral antibiotic therapy. The renal allograft functions remained stable and imaging studies did not show progression of the disease. Our data suggest reducing the immunosuppression and long-term antimicrobial therapy to achieve long-term renal allograft survival.

Background: Whitening creams are most commonly used by both men and women for beautifying and cleaning. These creams are not commonly sterile and contaminated during different stages of formulation from manufacturing to consumer. Pseudomonas aeruginosa, some gram negative bacteria and Staphylococcus aureus are involved in the contamination of cosmetic products. The use of microbial contaminated whitening cream may become health hazard to consumers. Objective: Microbial analysis of selected brands of whitening creams commonly used by the community of Pakistan. Methods: Four well-known brands of whitening creams were chosen for microbiological analysis and assigned coding as W-A, W-B, W-C and W-D respectively. Conventional culture were used for microbial analyze. Differential & Selective Media used for Identification of Microorganism and further confirmation of microbes were subjected by biochemical tests. Results: All four brands were observed contaminated with bacteria up to 106 CFU/g that finally more than the U.S.P. or F.D.A. recommended limit of less than 103 CFU/g for non-eye area. Growth of Klebsiella sp., Staphylococcus sp., and Pseudomonas sp was noted as well. Fungal population was not observed in any brand of whitening creams. Escherichia coli and actionmycetes were not present in all the samples. Klebsiella sp. and Pseudomonas sp. were detected in all brands within a range of 1. Conclusions: According to current microbial analysis there is higher load of total viable microbes in all samples. These contaminated products are health hazards to consumers. There should be checking during fabrication, packaging and storing of the cosmeceuticals brands by the regulatory bodies and intensive care the operation as well as the supply of cosmetics products among the health-care stores.

The effect of leaf extract of Momordica charantia on sexual behaviour of male wistar rats was evaluated in this study. The animals were randomly divided into three (3) groups of six (6) rats each. Group one (1) serving as control received distilled water while, groups two (2) and three (3) received 200mg/kg and 400mg/kg of the hydromethanol (20%:80%) extract respectively. Parameters assessed included the mount frequency (MF), mount latency (ML), intromission frequency (IF), intromission latency(IL), ejaculation frequency(EF) and ejaculation latency(EL). Results showed that the parameters were not significantly altered after 30 days treatment with 200mg/kg and 400mg/kg extract. It was concluded that M. charantia may not affect sexual activity in male wistar rats within the administered doses.

Introduction: Non-alcoholic fatty liver disease (NAFLD) has become a public health problem worldwide due to rising incidence of obesity and Type 2 diabetes mellitus. NAFLD is a common liver disorder that is strongly associated with insulin resistance and Type 2 diabetes mellitus. As a result of epidemic increase in hypertension, obesity, hypertriglyceridemia along with diabetes mellitus, prevalence of NAFLD and metabolic syndrome have increased globally. Objective: The aim of this study was designed to determine the proportion of NAFLD and metabolic syndrome in T2DM patients. Methodology: This was a cross sectional descriptive study conducted in medicine department, Rajshahi medical college, Rajshahi among ninety one T2DM patients. Abdominal ultrasonography for NAFLD detection and grading as well as measurement of blood pressue, BMI, waist circumference, HbA1c, lipid profile, liver function tests were done. All data were analysed by SPSS 16 and p value <0.05 was assumed as statistically significant in this study. Results: Out of ninety one DM patients 2/3rd (67%) were male and remaining 1/3rd (33%) were female. Mean age of them was 51.43±6.24 years. Among study population 80.2% were obese, 31.8 were hypertensive and 72.5% had hypertriglyceridemia. Proportion of NAFLD and metabolic syndrome in T2DM patients was 60.4% and 61.5% respectively. 52.7% had mild whereas 47.3% had moderate fatty change in liver. Female had proportionately higher NAFLD than male. It was also observed that NAFLD was proportionately increased in higher age group but both age and gender were statistically insignificant (p>0.05). Long standing and uncontrolled DM was significantly associated with higher proportion and severe form of NAFLD respectively (p<0.05). Hypertension was not significantly associated with frequency and severity of NAFLD (p>0.05) but increased BMI and waist circumference were significantly associated with increased occurance of NAFLD (p<0.05). Increased triglyceride and low HDL were significantly associated with both higher proportion and severity of NAFLD (p<0.05). AST, ALT and AST: ALT, serum bilirubin and albumin level were within normal limit in all study population. Metabolic syndrome was significantly associated with NAFLD (p<0.05). After calculation of BAAT score 65% T2DM patient with NAFLD had probable chance of fibrosis in liver. Conclusion: From this study it can be inferred that NAFLD is strongly associated with type2DM and metabolic syndrome and diabetic people should be kept under supervision and periodic clinical and laboratory evaluation to avoid progression of NAFLD to steatohepatitis and chronic liver disease.

Jateorhiza macrantha is a known medicinal plant used in ethno medicine for the treatment of diarrhea, cough, boils and ulcer. This study is aimed at evaluating the antibacterial activity of chromatography fractions from the aqueous ethanol extract of the leaves of Jateorhiza macrantha as a preliminary step towards isolation and characterization of its anti-bacterial constituent(s). The aqueous ethanol extract (AEE) was obtained by exhaustive cold maceration in 70% aqueous ethanol and further fractionated using vacuum liquid chromatography (VLC) techniques with a mobile phase gradient of n-hexane:chloroform:methanol (4:0:0, 3:1:0, 2:2:0, 1:3:0, 0:4:0, 0:3:1, 0:2:2, 0:1:3, and 0:0:4 v/v/v) into three fractions: non-polar (NPF1, eluted with n-hexane:chloroform:methanol 4:0:0, 3:1:0, 2:2:0 v/v/v), moderately polar (NPF2, eluted with n-hexane:chloroform:methanol 1:3:0, 0:4:0, 0:3:1, 0:2:2, 0:1:3 v/v/v) and polar (NPF3, eluted with n-hexane:chloroform:methanol 0:0:4 v/v/v). Antibacterial activity was evaluated using the agar well diffusion method against clinical isolates of pathogenic bacteria: Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pnuemoniae, and Salmonella typhi and the Minimum Inhibition concentration (MIC) extrapolated following the graphical approach. Functional group investigation was done using infra red spectroscopy. Three chromatography fractions NPF-1 –NPF3 obtained had MIC range of 5.0 mg/ml > MIC <0.26 mg/ml. NPF3 was relatively pure showing a single spot on TLC and its IR spectra are evidence for OH, N-H, C-O, C=C, and C-H stretching and deformation vibration frequencies typical of amino derivative of a lactone glycoside. The observed antibacterial activity justifies the ethno medicinal uses of Jateorhiza macrantha.

Pleomorphic adenoma is a benign tumor, the most common of the main salivary glands, especially in the parotid gland, its location at the palate is quite rare is quite rare. The aim of our work is to report a clinical case of a 60 year old patient who had a giant pleomorphic adenoma, and analyze the clinical, paraclinical and therapeutic aspects of this tumor.

Justicia insularis leaves widely used in African traditional medicine for the management of malaria, pains, diabetes, convulsion and bacterial infections was screened for its acute and sub-acute effects in Wistar rats. In acute toxic test, the leaf extract was orally administered to rats up to 5 g/kg in different doses. This was followed by observing the animals for signs of toxicity and mortality for 7 day. In sub-acute toxicity study, the rats were orally treated daily with J. insularis ethanol extract at doses of 200 mg/kg, 400 mg/kg and 600 mg/kg for 21 days. The rats used for control were given distilled water. All animals were weighed at 7 day intervals all through the study and the haematological, biochemical parameters and vital organs were all determined, at the end of the study. J. insularis ethanol leaf extract was practically non-toxic showing no mortality and visible signs of toxicity on acute exposure. The extract showed significant increase in the body weight of rats given 400 mg/kg and 600 mg/kg compared to control. The leaf extract showed significant increase in haematological indices, but there was no alteration in biochemical indices, and the vital organs as well. Findings in this study revealed that J. insularis was safe when orally administered, while we suggest further investigation to ascertain its effect on long-term administration.

Pre-eclampsia is one of the common complications of pregnancy and contributes significantly to high maternal and perinatal morbidity and mortality, especially in developing countries like Bangladesh. Objective: The aim of this study is to identify the risk factors and maternal and foetal outcomes of pre-eclampsia patients. Methods and Materials: This descriptive and observational study with data from the Department of Obstetrics and Gynaecology in Sir Salimullah Medical College and Mitford Hospital, Dhaka, during July 2011 to December 2011. Participants 123 pregnant women with pre-eclampsia included in the study. Main outcome measures Identify the risk factors associated with maternal & fetal complications, maternal and perinatal mortality & morbidity and incidence of pre-eclampsia. The patient with particular reference to age, parity, religion, occupation socioeconomic condition, gestational age, rapid weight gain, family history of hypertension and pre-eclampsia, obesity, new paternity, preexisting vascular disease, thrombophilias, previous history of pre-eclampsia, blurring of vision, pain in epigastrium, or pain in right upper quadrant, diabetes mellitus etc. Results: The incidence of pre-eclampsia is 4.3% and majority of the patients was found to be of 3rd decade. More than a half (51.2%) two third of the patient were primigravida. Maximum (65.9%) number was found in the gestational age group of 37 to 40 weeks. Lower abdominal pain 15.4%, Swelling of legs 15.4%, Headache 11.4%, less foetal movement 9.76% and Blurring of vision 8.13%. Mild pre-eclampsia was 44.0% and severe pre-eclampsia 56.0%. Fundal height had corresponded with 29 to 34 weeks in 42.0% patients, presentation was cephalic in 84.0%, fetal heart sounds was audible in 87.8% cases. The mean systolic and diastolic blood pressure was 164.76±9.34 mmHg and 101, 83±8.64 mmHg respectively and all patients had cephalic presentation. Fresh still birth was 3.5%, macerated still birth 1.8%, and Prematurity and IUGR were 7.0%. More than one third (36.4%) was low birth weight and male of female ratio of the babies were 1.1:1. According to APGAR score >7, were 51.5% and 81.8% during 1st and 5th minutes after birth respectively and 16.2% babies received neonatal resuscitation. Conclusion: Pre-eclampsia usually occurs in third trimester, and maternal outcome is better than fetal outcome although the maternal response to the treatment is in positive side.

Introduction: Mitral prosthetic thrombosis (MPV) is a rare but dangerous complication. It is suspected by clinical examination; the diagnosis of MPV is made by trans-thoracic echocardiography and held by the trans-esophageal echocardiography; or a fluoroscopy which shows a lack of prosthesis opening. The treatment is based on the early establishment of anti-coagulation and surgical cure. The thrombolysis is an alternative therapy. Case report: We report the case of a 47-year-old man who undergone a mitroaortic mechanical prosthesis replacement 6 years ago. However, since a year, his INR has been sub therapeutic. He presented a 5 days history of a chest pain and dyspnea. A passing at the intensive care diagnosed a shock according to the cool extremities, sweats, tachypnea and low blood pressure. The ECG showed atrial fibrillation with complete left bundle block. An emergency TTE was performed and revealed a MPV with high transvalvular gradient, while the aortic prosthesis was functional. The left ventricle was dilated and globally hypo contractile; TEE was emergently performed and showed à stuck leaflet caused by thrombus with associated with a thrombus at the left auricle. Patient’s hemodynamic condition required a surgical cure with thrombectomy of the left atrium. Conclusions: Through this case we highlight the interest of echocardiography to diagnose the etiology of shock, and the importance of early management to avoid any complications.

The success in the treatment of erectile dysfunction and subsequent improvement of quality of life by the three approved phosphodiesterase type-5 inhibitors (sildenafil, tadalafil and vardenafil) has led to an explosion of illicit sexual performance enhancement products. Several cases of adulteration of herbal aphrodisiac products with Phosphodiesterase type-5 inhibitors (PDE-5) and/or their unapproved analogues’ have been reported worldwide. Therefore, the aim of this research is to evaluate herbal aphrodisiac preparations for the presence of sildenafil in northwest Nigeria. An isocratic Reverse Phase-High Performance Liquid Chromatography (RP-HPLC) for the determination of sildenafil was adopted and modified for this study. Fifty aphrodisiac herbal preparations were sampled and screened for the presence of sildenafil. Calibration curve was found to be linear within the concentration range of 10-50 µg/ml (r2 = 0.999); the method is precise (% RSD <2) and accurate (% recovery 98-100). Sixteen samples (32 %) were identified to be adulterated with sildenafil; the compounded concentrations in the products were found to be within the range of 0.45-39.8 mg of sildenafil per dose. Thus, consumption of these products could lead to serious health risks; hence the need for an immediate intervention by relevant stakeholders to safeguard public health.