Poisoning after eating puffer fish containing highly lethal tetrodotoxin (TTX) is widespread in Asia. In 2008, naïve inland populations in Bangladesh were exposed to cheap puffer fish sold on markets. In three outbreaks, 141 patients with history of puffer fish consumption were hospitalized. Symptoms of poisoning included perioral paraesthesia, tingling over the entire body, nausea and vomiting, dizziness, headache, abdominal pain and muscular paralysis of the limbs. Seventeen patients (12%) died from rapidly developing respiratory arrest. Blood and urine samples from 38 patients were analyzed using a TTX-specific enzyme-linked immunoassay (ELISA). Medium to high TTX levels were detected (1.7-13.7 ng/ml) in the blood of 27 patients. TTX was below detection level (< 1.6 ng/ml) in 11 blood samples but the toxin was detected in urine. Ten patients had blood levels above 9 ng/ml and developed paralysis; seven of these died. The remaining patients recovered with supportive treatment. High concentrations of TTX and its analogues 4-epiTTX and 4,9-anhydroTTX were also found in cooked puffer fish by post-column liquid chromatography-fluorescence detection. To prevent future instances of puffer fish poisoning of this magnitude, measures should be implemented to increase awareness, to control markets and to establish toxicological testing. To improve the management of this and other poisoning in Bangladesh, facilities for life-saving assisted ventilation and related training of healthcare personnel are urgently needed at all levels of the health system.

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Objective: This study aimed to compare the efficacy of diode laser and coblation tonsillectomy in paediatric patients in relation to operative time, amount of blood loss, post operative pain, healing of tonsillar fossa and returns to normal diet. Methods: A total of 200 patients ,100 for coblaton and 100 for diode laser, aged 3-12 years with recurrent tonsillitis with or without snoring and sleep apnoea were recruited. Participants were prospectively randomised to diode laser and coblation tonsillectomy. Operative time and blood loss were recorded. Pain was recorded by VAS or assessed by using analgesic. Results: The operative time were recorded 07-15 minutes,mean 10 minutes in coblation group and 12-20 minutes ,mean 14 minutes in laser group., Blood loss was recorded 0-15 ml mean 8 ml in coblation group and 10-25 ml mean 13.5 ml in diode laser group . However, at post-operative day seven, the diode laser tonsillectomy group had significantly higher pain scores compared with coblationtonsillectomy groups.Coblation group started normal soft diet on day 5 whereas diode laser started on day 8 Conclusion: Coblation tonsillectomy is associated with less operative time and blood loss, early returns to normal diet and less pain score in comparison to Diode laser tonsillectomy Bangladesh J Otorhinolaryngol; October 2017; 23(2): 140-145

Introduction: Hs-CRP is a nonspecific marker of the inflammatory response has been associated with development of type 2 diabetes mellitus. Cardiovascular disease is a major consequence of diabetes. DM confers a 2-4 fold rise in cardiovascular risk compared with general population. One of the many modifiable risk factors for both cardiovascular disease and diabetes is diet. Fiber is an important dietary factor that may modify the risk of both diseases. Material & methods: The current study is an attempt to explore the association of dietary fiber on inflammatory marker, hs-CRP in type2 diabetic subjects. Total 80 diabetic subjects were included in this study of which 40 were taking more dietary fiber and 40 were taking relatively low dietary fiber. Serum hs-CRP was measured by chemiluminescent immunometric assay (DPC Biermann Gmbh., Germany). Nutrient information was calculated using a pretested food recall questionnaire prepared by nutritionists for usual Bangladeshi food articles. Results: Hs-CRP was significantly higher in subjects taking low dietary fiber. There was significant negative correlation between CRP of subjects taking high and low intake of dietary fiber. Conclusion: So, low dietary fiber consumption maybe a possible causal factor of raised CRP. Type 2 diabetic patients who took less dietary fiber in their diets had elevated blood CRP levels. DOI: http://dx.doi.org/10.3329/bjms.v11i2.11434 Bangladesh Journal of Medical Science Vol. 11 No. 02 April 2012: 117-120