Globally the incidence and prevalence of chronic kidney disease (CKD) is increasing day by day. Various biochemical and hematological abnormalities are associated with CKD that leads to morbidity and mortality. The aim of this observational study was to evaluate the socio-demographic profile, biochemical and hematological parameters of chronic kidney disease patients in Mymensingh Medical College Hospital, Mymensingh, Bangladesh from January 2020 to December 2020. This study also showed variation of biochemical parameters with lower calcium and hemoglobin level which was due to improper renal function. A total of 179 End Stage Renal Disease (ESRD) patients were enrolled in this study. Male and female ratio was 2.086:1. This study had more male patients than female. The Mean±SD age of the patient was 46.14±14.25 years and maximum of the CKD patients belonged to the age group of 41-60 years. This study depicted Glomerulonephritis was the leading cause of CKD. Second common cause was Diabetes mellitus. A portion of CKD was unknown etiology (CKDu) which was found 17.31%. Routine biochemical parameters were also seen in this study. This study showed that the majority of the patients were living below the level of poverty and came from rural area. This study aimed to evaluate the derangements of serum biochemical parameter and the association of risk factors with CKD. These demographic character, biochemical profile and etiology have association with CKD progression. So, early evaluation of these parameters may reduce the incidence of CKD.

Among patients with chronic kidney disease stage-5 who are treated with dialysis, intradialytic complications commonly occur during routine hemodialysis (HD). It could be either patient related or mechanical. Protein catabolic rate during hemodialysis is a determinant of the mortality. nPCR was aimed to targets according to International guideline. This observational study was conducted in the Department of Nephrology, Mymensingh Medical College Hospital, Bangladesh from January 2020 to December 2020 to compare two groups of nPCR and different value of biochemical parameters. This study was involving all patients and inclusion criteria were patients who underwent routine HD for at least three months. All patients under-went conventional intermittent HD with low-flux dialyser. A total of 179 patients enrolled. Serum albumin, serum calcium, phosphate, hemoglobin and pre-dialysis urea, post dialysis urea were measured from blood sample. The nPCR was calculated by the standard international equation. nPCR value of 14.0% patients was more than 1.0 gm/kg/day and average nPCR (mean±SD) of all patients was 0.903±0.09gm/kg/day and 86.0% patients nPCR was less than 1.0 gm/kg/day. Biochemical parameters were not significantly differing between two groups. The nPCR is an indicator, can help the determination of nutritional status. This study aimed to find out the intradialytic complications, mean value of nPCR and correlation of biochemical parameters among ESRD patients on maintenance hemodialysis.

Neutron energies and angular distributions were measured in 9 Be(a,n) 12 C reaction for a energies of 5.5 and 6.5 MeV. Three major neutron groups were observed in the spectrum, which correspond to the ground and first two excited states of 12 C. Measured data could only be explained by the TALYS calculation if reaction at more than one location within the target is considered for a given beam energy. The preferred locations are driven by the resonance energy levels existing in 13 C. Neutron yield due to the 9 Be breakup process was determined which is found to be 12.6 +/- 0.2% and 18.4 +/- 0.5% of the total reaction cross-section for 5.5 and 6.5 MeV respectively.

Neutron energies and angular distributions were measured in 9Be(α,n)12C reaction for α energies of 5.5 and 6.5 MeV. Three major neutron groups were observed in the spectrum, which correspond to the ground and first two excited states of 12C. Measured data could only be explained by the TALYS calculation if reaction at more than one location within the target are considered for a given beam energy. The preferred locations are driven by the resonance energy levels existing in 13C. Neutron yield due to the 9Be breakup process was determined which is found to 12.6 ± 0.2% and 18.4 ± 0.5% of the total reaction cross-section for 5.5 and 6.5 MeV respectively.

Double differential neutron fluence distributions were measured in the 7Li(p,n)7Be reaction for proton beam energies 7, 9 and 12 MeV. Seven liquid scintillator based detectors were employed to measure neutron fluence distributions using the Time of Flight technique. Neutron ambient dose equivalents were determined from the measured fluence distribution using ICRP (International Commission on Radiological Protection) recommended fluence to dose equivalent conversion coefficients. Neutron dose equivalents were also measured using a conventional BF3 detector based REM counter. Ambient dose equivalent measured by the REM counter is found to be in agreement with that determined from the neutron fluence spectra within their uncertainties. Angular distributions of the ambient dose equivalents were also determined from the measured fluence distributions at different angles.

Acute kidney injury (AKI) requiring dialysis (AKI-D) is an important health care burden and is associated with very high in-hospital mortality. Timely initiation of dialysis in AKI is fundamental to achieve treatment goals and to provide solute clearance and removal of excess fluid while awaiting the recovery of kidney function. The primary outcome of interest of the study was recovery of sufficient kidney function to discontinue haemodialysis therapy and complete recovery of renal function. This prospective observational study has been conducted in Mymensingh Medical College Hospital, Bangladesh from September 2019 to February 2021. All adult patients with AKI-D were included in the study. All patients were followed up till death or complete recovery or for a maximum period of six month. A total of 134 patients of AKI-D were included in the study with the mean age of 42.3±15.7 years. Male (54.5%) were slightly more than female with a male to female ratio of 1.2:1. Diabetes and hypertension were present in 16 (11.9%) and 47 (35.1%) patients respectively. The causes of AKI were sepsis (35.1%), urinary tract infection (34.3%), acute watery diarrhoea (9.7%), leptospirosis (11.2%), obstetric (10.4%), malignancy (8.2%), post renal obstruction (8.2%), drugs (7.5%), surgery (18.7%), rapidly progressive glomerulonephritis (6%), COVID 19 (5.2%), rhabdomyolysis (4.5%), intestinal obstruction (3.7%), acute gastroenteritis (2.2%), wasp bite (2.2%), insecticide poisoning (1.5%), star fruit toxicity (1.5%), haemolytic uremic syndrome (0.7%) and unknown (1.5%). Mean number of dialysis requirement was 5.9±8.6 and length of hospital stay was 15.4±10.5 days. Out of 134 patients, 95(70.9%) were discharged from hospital and 39(29.1%) died in hospital. Total death of patients during the study period were 49(36.6%) including home death of 10(7.5%) patients. Complete recovery of kidney function was achieved in 70(52.2%) patients and partial recoveries of kidney function who can survive without dialysis were observed in 12(9%) patients. Three (2.2%) patients remain on dialysis and 85(63.4%) patients survived during the study period. Survival rate was significantly higher in patients with ≤40 years (72.6%) and significantly lower in patients with malignancy (18.2%) and post renal obstruction (27.3%). Outcomes of patients with AKI-D remain poor. Advanced stage of AKI, older age, late presentation, malignancy, nutritional deficiency and delay at initiation of dialysis were associated with high mortality and reduced survival.

This observational study was carried out in the Department of Nephrology, Mymensingh Medical College Hospital, Bangladesh from January 2020 to December 2020. A total of 179 patients were included in this study according to inclusion and exclusion criteria. Informed written consent was taken from each patient. All patients were underwent detail history taking, thorough physical examination and relevant investigations. Data collection was conducted through a structured questionnaire. Collected data were analyzed using the statistical software SPSS 23.0. Mean age ±SD of the study patients was 47.06±14.1 with a majority in age group 41-50 years. Male predominance was observed with a male: female ratio of 2.19:1 and 68.7% male patients. Level of pre-dialysis, post-dialysis urea in the study population was 123.77±26.86mg/dl, 50.27±15.70mg/dl respectively and mean ±SD of Urea Reduction Ratio (URR) in hemodialysis (target >65.0%) was 67.2±1.9. Most of the 8 hours (two times) per week hemolysis patients could not achieve the target value of dialysis adequacy parameters. On the other hand, maximum people in 12 hours (three times) per week hemodialysis group achieved the target value of dialysis adequacy parameters. It is important to calculate Kt/V or URR and individualize the dialysis doses for each patient.

The 1,3,4-thiadiazole nucleus is a ubiquitous and intrinsic ingredient of a wide diversity of naturally occurring molecules and therapeutic medicines, and this moiety is realized as one of the immensely valued heterocyclic nuclei. The thiadiazole core is found in a wide range of drugs, including analgesic, anti-inflammatory, antineoplastic, antiepileptic, anti-bacterial, antitubercular, and antiviral agents. Thiadiazole and its derivatives have established themselves as pharmacologically relevant scaffolds due to their broad and potent activity. In another, diversely substituted indazole derivatives have a wide range of functional groups and possess a wide range of biological activities; therefore, these molecules acquired immense consideration in the field of biological chemistry. In this study, an attempt was made to review the structural alterations on several thiadiazole molecules for varied pharmacological actions using latest research discoveries on this nucleus. The advancements in the biological potential of indazole-based compounds are also highlighted.

The nucleus 1,2,4-triazole is found in a wide variety of biologically active molecules. Interest in 1,2,4-triazole chemistry in recent decades has been increasing rapidly because of diverse biological and pharmaceutical applications, mostly due to the diversity of this N-heterocyclic moiety in medicinal chemistry. More than 35 drugs containing this nucleus have been released on the market. The nucleus of the 1,2,4-triazole is metabolically stable and interacts as a pharmacophore by serving as a hydrogen bond acceptor and donor at the active site of a receptor. The triazole nucleus can improve the drug’s pharmacological profile by increasing the solubility of the ligand due to its polar character. This chapter highlights the unique features about the potential possible role of 1,2,4-triazole derivatives and summarizes biological, and pharmacological activities.

This work describes the iodine-catalyzed N -methyl morpholine-promoted hydration of alkynes via Markovnikov type addition. The developed protocol provides a direct approach to synthesize methyl ketones under metal-free condition. A series of aromatic alkynes embedded with electron-donating and electron-withdrawing groups were well-investigated to give the corresponding products in good to high yields.

Benzisoxazole analogues are a privileged scaffold in biological chemistry and affirmed in the increased number of investigations on benzisoxazole-embedded pharmacological molecules. The distinct benzisoxazole molecules also exhibit promising anti-glycation, anticancer, antibacterial, anti-inflammatory and other activities. This overview focuses on the current status of medicinal chemistry in terms of a comprehensive and broad overview of the many benzisoxazole analogues, as well as their appearances as initial building blocks in a variety of core structures to support trials in therapeutic applications. The increasing series of developments leading benzisoxazole-containing highly active molecules supports to the hope that these scaffolds will become more promising drug candidates. In this perspective, the current chapter holds greater attention of the readers in formulating advanced drug molecules embedded with benzisoxazole motifs.

The virtual molecular library contains phenolic group at the intermediate stage was investigated which having a potency to treat Type 2 Diabetes Mellitus. The designed molecules have shown comparable in-silico binding affinity to marketed thiazolidinedione (TZD) class of drug toward peroxisome proliferator activated receptor-γ (PPAR-γ) protein. Interestingly, change of phenolic group with 5-hydroxy quinolone in pioglitazone has shown high structural conservation in PPAR-γ ligand binding domain (LBD) with pioglitazone having better affinity. This information might be very useful to identify novel lead compounds for further development toward Type 2 Diabetes Mellitus treatment targeting PPAR-γ.

This work describes the iodine-catalyzed N-methyl morpholine-promoted hydration of alkynes via Markovnikov type addition. The developed protocol provides a direct approach to synthesize methyl ketones under metal-free condition. A series of aromatic alkynes embedded with electron-donating and electron-withdrawing groups were well-investigated to give the corresponding products in good to high yields.

Acute kidney injury (AKI) requiring dialysis is an important health care burdenand is associated with very high in-hospital mortality. As no specific treatment is available toreverse AKI, the management remains supportive, including optimized fluid, electrolyte andacid-base balance, adjusting the dose of potentially nephrotoxic medications or avoidingsecondary haemodynamic and nephrotoxic kidney injury with timely initiation of dialysis.Timely initiation of dialysis in AKI is fundamental to achieve treatment goals and to providesolute clearance and removal of excess fluid while awaiting recovery of kidney function.

Glomerular disease is one of the most important causes of chronic kidney disease in developing countries like Bangladesh as well as the whole world. The pattern of glomerular disease varies in different countries and can have different clinical presentations. The aim of the study was to analyze the clinical profile and to determine the histological pattern of glomerular diseases in a large tertiary care hospital in Bangladesh. All kidney biopsies performed in Mymensingh Medical College Hospital, Bangladesh from October 2018 to March 2020 were prospectively analyzed in the study. A total of 101 patients with kidney biopsy were examined by clinical and laboratory findings and by light and immuno-fluorescence microscopy. The mean age was 30.0±14.6 years and 50(49.5%) were male and 51(50.5%) were female with a male to female ratio of 1:1. The clinical syndromes namely nephrotic syndrome, nephritic syndrome, nephrito-nephrotic presentation, RPGN like presentation, macroscopic haematuria and asymptomatic urine abnormality were present in 31.7%, 34.5%, 22.8%, 11.9%, 19.8% and 10.9% patients respectively. The most common histological varieties found in the study were mesangial proliferative glomerulonephritis (MesPGN) (18.8%) and focal segmental glomerulosclerosis (FSGS) (18.8%). Other histopathological pattern among the studied subjects revealed minimal change disease (MCD) in 5.9%, membranous nephropathy (MN) in 7.9%, membranoproliferative glomerulonephritis (MPGN) in 16.8%, IgA nephropathy in 5%, IgM nephropathy in 2%, IgG nephropathy in 2%, diffuse proliferative glomerulonephritis (DPGN) in 1%, focal proliferative glomerulo-nephritis (FPGN) in 3%, crescentic GN in 3%, lupus nephritis (LN) in 13.9%, amyloidosis in 1% and fibrillary glomerulopathy in 1% patient. The pattern of glomerular disease found in this study was similar to other studies performed in Bangladesh with a little variation. It may guide the future researchers to establish a national kidney biopsy registry in Bangladesh.

This work describes an easy way to perform approach for the transformation of arylmethyl ketones to α-ketoamides using secondary amines as starting materials in the presence of iodine as a catalyst in water under peroxide free reaction conditions. The established amidation reaction proceeds via α-C(sp3)-H functionalization and C-N bond formation approaches in water at ambient temperature. On the other hand, a novel and straightforward synthesis of 2,4-disubstituted-1,3,5-triazines via nickel-catalyzed cyclization of amidines with DMSO as one-carbon synthon has been developed. The developed strategy proceeds via C-N bond formation.

Conventional liquid scintillator (BC501A) and pulse shape discrimination capable plastic scintillator (EJ-299-33A) based detector of dimension; 5 inch diameter and 5 inch long, have been used to study pulse height response for quasi-monoenergetic neutrons of energy in the range 3 to 15 MeV generated using 7Li(p,n)7Be reaction. Scintillation light output of plastic scintillator having pulse shape discrimination property is found to be 75% of the liquid scintillator at neutron energy (maximum recoil proton energy) of 3 MeV which improves with the increase in energy. Functional dependence of the scintillation light output in terms of recoil protons energy has been determined for the liquid and the plastic scintillator detectors for neutron energy in the range 3 to 15 MeV. This functional dependences were used in the Geant4 simulation to calculate the pulse height responses at several neutron energies.

This cross sectional comparative study was conducted in the Nephrology and Medicine outdoor and in-patients department of Mymensingh Medical College Hospital, Bangladesh from April 2014 to March 2015. A total of 100 patients with CKD and 100 healthy subjects were included in the study. Data were collected by interview of the patients, clinical examination and laboratory investigations using a semi-structured case record form. Among all subjects, 50.0% had no CKD and 50.0% patients had CKD: Stage 3 CKD were 8.5%, CKD Stage 4 CKD were 21.0%, CKD Stage 5 CKD were 20.5%. Serum creatinine was 4.32±3.08mg/dl in patients with CKD and 1.00±0.22mg/dl was in healthy subjects. Mean±SD of CCR/ml/min was found 17.67±11.63ml/min in patients with CKD and 79.31±13.31ml/min was found in healthy subjects. On the other hand, Mean±SD CCCR/ml/m/1.73m² was found 19.79±12.85 ml/m/1.73m² in patient with CKD and healthy subjects had 83.83±13.33 ml/m/1.73m². Urinary creatinine was 45.59±15.63 & 57.66±11.45mg/dl respectively. CKD-EPI eGFR was 22.10±15.02 & 90.61±23.27ml/m/1.73m²; MDRD eGFR was 22.15±14.18 & 89.35±26.19 ml/m/1.73m² respectively. Difference between all the variables between CKD group and healthy group was found statistically significant (p<0.001). CKD-EPIeGFR and MDRDeGFR were increased both in CKD patients and healthy subjects in respect to CCR and CCCR. There was a strong positive correlation between CCCR (ml/m/1.73m2) and CKD-EPI (ml/m/1.73m²) among all patients (r=0.934 and p<0.001) and also a positive correlation of CCCR with MDRD among all patients (r=0.913 and p<0.001). A positive correlation of CCCR was found with CKD-EPIeGFR among CKD patients (r=0.848 and p<0.001). A positive correlation of CCCR was also found with MDRDeGFR among CKD patients (r=0.841, p<0.001). There are positive correlations between CCCR and CKD/EPI among healthy subjects (r=0.616 and p<0.05) and between CCCR with MDRD among healthy subjects (r=0.568 and p<0.05). Various formulae were used to calculate GFR on the basis of serum creatinine levels. The Overall correlation of population (healthy and CKD patients) between CCCR and CKD EPI and MDRD formula was (r=0.93 and 0.91) respectively, among CKD patients it was (r=0.848 and r=0.841) in healthy subjects it was (r=0.616 and r=0.568) respectively. CKD EPI eGFR and MDRD eGFR formula had fairly good correlation with conventional 24 hours creatinine clearance in both CKD patient and healthy subjects, there was even more strong correlation especially in CKD patients. The performance of CKD-EPI equation is better than MDRD equation to estimate the eGFR in both CKD patients and healthy subjects.

This report describes an efficient transition-metal-free process toward the transfer hydrogenative cascade reaction between nitroarenes and amines or alcohols. The developed redox-economical approach was realized using a combination of KOtBu and Et3SiH as reagents, which allows the synthesis of benzimidazole derivatives via σ-bond metathesis. The reaction conditions hold well over a wide range of substrates embedded with diverse functional groups to deliver the desired products in good to excellent yields. The mechanistic proposal has been depicted on the basis of a series of control experiments, mass spectroscopic evidence which is well supported by density functional theory (DFT) calculations with a feasible energy profile.

Acute post-streptococcal glomerulonephritis (APSGN) is the commonest cause of acute glomerulonephritis (AGN), which usually present with gross hematuria, mild edema, oliguria, hypertension and varying degree of renal insufficiency. It is more common among the population of school going age where poverty, overcrowding and poor hygienic conditions are prevailing. This cross sectional observational study was aimed to know the socio-demographic variables, clinical profile and immediate outcome of AGN in hospitalized children and was conducted in the Pediatric department of Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh from November 2014 to April 2015. A detailed history was taken from the parents in each case with a written questionnaire. A written consent was also taken from the guardian of the including patients and also permission was taken from the ethical committee of MMCH. Thorough clinical examination and available relevant investigations were done in all patients. Progresses of the patient were monitored by daily clinical examinations and also by investigations. Data were analyzed by statistical package for social science (SPSS) windows version 18. Results were verified by doing standard test for significance. Among total 60 cases male was 58.3% & female was 41.7%. The common age group of presentation was between 7-12 years (73%), peak age of incidence was 7-9 years. Most of them came from low socioeconomic status (83.3%), 63.3% from rural area with average 5-6 member's family size. Most of the parents were illiterate. History of (H/O) skin infection was present in 35(58.3%) patients, 15(25%) had H/O sore throat, 15% did not give any H/O infection before presentation. Average duration of gap between infection and appearance of clinical feature was 7-14 days in 73.40%and 15-21 days was in 45.7% in case of sore throat & skin infection respectively. Almost all (95%) patients presented with puffiness of face, others presented with scanty micturition, gross hematuria, respiratory distress, fever, convulsion and altered sensorium. Edema (75%), hypertension (88.3%), pallor (38%), tachypnea (25%), tachycardia (26.7%) were the important clinical findings. Microscopic hematuria was present among 96.66% patients; low complement level was found in 85% cases. There is significant association between low socioeconomic statuses with more hospital stay. Only one patient died due to heart failure and 98.3% patient had complete recovery. Results of this study conclude that most of the patients came from rural illiterate family with low socioeconomic background. Skin infection is the commonest cause of acute glomerulonephritis. Edema, scanty micturation, hematuria and hypertension are the common mode of presentation. Heart failure and hypertensive encephalopathy are the common complication of AGN. Immediate prognosis of AGN was excellent.