Next-generation sequencing (NGS) of circulating tumor DNA (ctDNA) supports blood-based genomic profiling but is not yet routinely implemented in the setting of a phase I trials clinic. TARGET is a ...molecular profiling program with the primary aim to match patients with a broad range of advanced cancers to early phase clinical trials on the basis of analysis of both somatic mutations and copy number alterations (CNA) across a 641 cancer-associated-gene panel in a single ctDNA assay. For the first 100 TARGET patients, ctDNA data showed good concordance with matched tumor and results were turned round within a clinically acceptable timeframe for Molecular Tumor Board (MTB) review. When a 2.5% variant allele frequency (VAF) threshold was applied, actionable mutations were identified in 41 of 100 patients, and 11 of these patients received a matched therapy. These data support the application of ctDNA in this early phase trial setting where broad genomic profiling of contemporaneous tumor material enhances patient stratification to novel therapies and provides a practical template for bringing routinely applied blood-based analyses to the clinic.
Increased COVID‐19 vaccine hesitancy presents a major hurdle in global efforts to contain the COVID‐19 pandemic. This study was designed to estimate the prevalence of adverse events after the first ...dose of the Covishield (AstraZeneca) vaccine among physicians in Bangladesh. A cross‐sectional study was conducted using an online questionnaire for physicians (n = 916) in Bangladesh. Physicians who received at least one dose of the COVID‐19 vaccine were included. The study was carried out from April 12 to May 31, 2021. More than 58% of respondents (n = 533) reported one or more adverse events. Soreness of the injected arm (71.9%), tiredness (56.1%), fever (54.4%), soreness of muscles (48.4%), headache (41.5%) and sleeping more than usual (26.8%) were the most commonly reported adverse events. Most vaccine‐related reactogenicities were reported by the younger cohorts (<45 years). The majority of respondents reported severity of reactogenicity as “mild,” experienced on the day of vaccination, and lasting for 1–3 days. The most common reactogenicity was pain at the injection site; the second most common was tiredness. Almost half (49.2%) of the physicians took acetaminophen (paracetamol) to minimize the effects of vaccine reactogenicity. Multivariate logistic regression analyses showed that physicians with diabetes and hypertension (OR = 2.729 95% CI: 1.282–5.089) and asthma with other comorbidities (OR = 1.885 95% CI: 1.001–3.551) had a significantly higher risk of vaccine‐related reactogenicities than physicians without comorbidities. Further safety studies with larger cohorts are required to monitor vaccine safety and provide assurance to potential vaccine recipients.
Background: Hepatitis E virus (HEV) infection during pregnancy has increased mortality up to 30% in the 3rd trimester.Methods: A prospective study was conducted on the HEV positive pregnant patient ...with sign symptoms of encephalopathy admitted at the ICU of BRB hospital Ltd during the period of January 2018 to December 2018. During this period 26 patients were admitted. The serum of pregnant women was tested for HEV IgM by ELISA method and positive women were recruited for the study. Maternal variables such as gestational age, clinical progression, worsening of the disease, laboratory parameters, obstetric outcome, and fetal outcome were noted. All data were entered in SPSS 16 and analyzed. This study was ethically approved by the ethical review committee of BRB hospital Ltd.Results: Among 26 HEV-positive patients, the mean age was 27.46 years. Among them 11 (42.3%) were primi and the rest were multigravida, 5 (19.2%) were in the first trimester, 9 (34.6%) were in the 2nd trimester and 12 (46.15%) were in the 3rd trimester of pregnancy.17 patients (65.4%) were housewives and 9 (34.6%) were service holders. Three patients (11.5%) were illiterate, 16 patients (61.5%) have completed primary level of education and 7 (26.9%) were completed higher level of education. Most of the patients were from middle-class families that are 18 patients (69.23%), 3 patients (11.5 %) were from poor social class, and the rest from upper social class is 5 (19.2%).Conclusions: HEV infection during pregnancy has many serious fetomaternal complications including maternal and fetal death.
•Maternal periodontal disease is a risk factor for adverse pregnancy outcome.•Periodontal disease can increase the risk of preterm-birth with low birth weight.•Inadequate vitamin D status can promote ...the genesis of periodontal disease.•Benefits of prenatal sunlight exposure on fetal health and beyond should be explored.•Proper oral health care during pregnancy should be encouraged.
Studies have shown a relationship between maternal periodontal diseases (PDs) and premature delivery. PDs are commonly encountered oral diseases which cause progressive damage to the periodontal ligament and alveolar bones, leading to loss of teeth and oral disabilities. PDs also adversely affect general health by worsening of cardiovascular and metabolic diseases. Moreover, maternal PDs are thought to be related to increasing the frequency of preterm-birth with low birth weight (PBLBW) in new-borns. Prematurity and immaturity are the leading causes of prenatal and infant mortality and is a major public health problem around the world. Inflamed periodontal tissues generate significantly high levels of proinflammatory cytokines that may have systemic effects on the host mother and the fetus. In addition, the bacteria that cause PDs produce endotoxins which can harm the fetus. Furthermore, studies have shown that microorganisms causing PDs can get access to the bloodstream, invading uterine tissues, to induce PBLBW. Another likely mechanism that connects PDs with adverse pregnancy outcome is maternal vitamin D status. A role of inadequate vitamin D status in the genesis of PDs has been reported. Administration of vitamin D supplementation during pregnancy could reduce the risk of maternal infections and adverse pregnancy outcomes. As maternal PDs are significant risk factors for adverse pregnancy outcome, preventive antenatal care for pregnant women in collaboration with the obstetric and dental professions are required.
Background: Couple suffering from secondary subfertility is a major health concern. Pattern involved both the male and female factors and sometimes unknown aetiology. This cross-sectional study was ...carried out to see the pattern of secondary subfertility among the couples attended selected fertility centres of Dhaka city to ascertain the risk factors. Methods: A cross sectional study was carried out among the couples attended from September 2011 through March 2012. There were 190 couples were interviewed with questionnaire using the purposive sampling method and analyzed by SPSS 20. Results: Among the 190 couples suffering from secondary subfertility, 52% cases female factors, 13% male factors, unexplained 27% and both male and female factors lie behind 8% of cases. Among the female causes 31% were tubal factors, 26% cases PCOD, ovulatory disorders and endometriosis 21% and 22% respectively. Result revealed that the mean age of the female was 32 and 54% were obese. The women who had tubal factors had H/O MR or D&C in significant number. Female age, weight menstrual irregularity, medical disorders and number of previous abortion were significantly correlated with secondary subfertility .Among the male factors 76% cases shows abnormal semen parameters, 12% cases coital problem, 12% cases ejaculatory problem due to chronic disease like chronic HTN, DM. Conclusions: This study concluded that proper evaluation with details personal, medical and gynaecological history of female and also male factors need to evaluate the cause and formulate a management plan to treat the secondary subfertile couple. Keywords: BMI, PCOD, Subfertility, Tubal factors
The decision forutilization of a space of a retained deciduous molar to alleviate crowding in late mixed dentition is one of the critical aspects in orthodontic treatment.Hence, the aimof the ...treatment hereis to use the extraction spaces properly to relieve severe crowding and align both the arches to the point where a stable overjet/overbite exist. This case report presenting a 13-year-old female adolescent with severe crowding in both upper and lower jaw and a convex profile. Although she was initially anxious to extract her teeth to treat her case but also she was looking for desirable results. The case was later treated in a conventional orthodontic approach with extraction ofthree 1stpremolars. It was quite challenging to make the best use of the space of missing lower right 2nd premolar after extraction of deciduous second molar on that sideto relieve severe crowding. However; at the end of the treatment, the patient expressed satisfaction with the results- proper bite, smile and most importantly esthetics. This case report demonstrates successful treatment of an adolescent patient with severe crowding by proper utilization of the extraction spaces.
Bangladesh Journal of Medical Science Vol.19(4) 2020 p.763-768
Background: Globally postpartum haemorrhage remains a leading cause of maternal death. It affects only 1-2% of postnatal women. This low incidence of secondary PPH and linkage to maternal morbidity ...rather than mortality was the reason for the little attention among obstetricians, but it is recently gaining importance and interest with the increase morbidity and mortality related to secondary PPH. Methods: A retrospective study was conducted on the diagnosed patients of secondary PPH admitted in Enam Medical College and Hospital, Dhaka, Bangladesh, from January 2015 to December 2016. Among 33 cases of secondary PPH age of the patients, parity, mode of delivery, causes and management were noted from medical records. All data was analyzed by SPSS16. Results: Among 33 patients 14 (42.4%) were primi and 19 (57.6%) were multipara, age between 18 to 38 years, majority admitted 2nd and 3rd week after delivery. Among 33 patients 12% delivered vaginally at home and 30% vaginally at hospital and 58% undergone LUCS. We found 34% retained bits of placenta, 27% uterine wound dehiscence, 24% retained clots and 15% endometritis as causes. Less than 3 units blood needed in 22 (66.7%) patients and 11 (33.3%) needed more than 3 units. About 6 (18%) patients were treated conservatively, MVA were needed in 18 (55%) patients, repair of wound in 4 (12%) and TAH was in 5 (15%). Conclusions: Secondary PPH is increasing may result in significant maternal morbidity as well as mortality. More study needed to identify the risk factors and causes to reduce maternal mortality and morbidity. Keywords: MVA, Secondary PPH, TAH, Wound Dehiscence
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