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Skeletal muscle mass reduction has been implicated in insulin resistance (IR) that promotes cardiometabolic diseases. We have previously reported that arsenic exposure increases IR concomitantly with the reduction of skeletal muscle mass among individuals exposed to arsenic. The arsenic methylation capacity is linked to the susceptibility to some arsenic exposure-related diseases. However, it remains unknown whether the arsenic methylation capacity affects the arsenic-induced reduction of muscle mass and elevation of IR. Therefore, this study examined the associations between the arsenic methylation status and skeletal muscle mass measures with regard to IR by recruiting 437 participants from low- and high-arsenic exposure areas in Bangladesh. The subjects’ skeletal muscle mass was estimated by their lean body mass (LBM) and serum creatinine levels. Subjects’ drinking water arsenic concentrations were positively associated with total urinary arsenic concentrations and the percentages of MMA, as well as inversely associated with the percentages of DMA and the secondary methylation index (SMI). Subjects’ LBM and serum creatinine levels were positively associated with the percentage of DMA and SMI, as well as inversely associated with the percentage of MMA. HOMA-IR showed an inverse association with SMI, with a confounding effect of sex. Our results suggest that reduced secondary methylation capacity is involved in the arsenic-induced skeletal muscle loss that may be implicated in arsenic-induced IR and cardiometabolic diseases.

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Background: Malnutrition is a state of nutrition in which a deficiency and excess of energy, protein and other nutrients causes measurable adverse effects on tissue or body function and clinical outcome.  The aim of study were to find out proportion of malnutrition during hospital admission and to observe the change of nutritional status of the patients during hospital stay. Materials and methods: This is a serial cross sectional study performed at Gastroenterology Department of Bangabandhu Sheikh Mujib Medical University, Dhaka during a period of May to December 2009. The nutritional status was assessed using Body Mass Index (BMI) and Mid Arm Circumference (MAC). Statistical analysis was performed using SPSS program and simple frequency distribution table. 202 patients were included in this study, 114 were male and 88 were female. 32 patients were over 60 years of age. Results: Out of 202 patients, 57 patients had chronic liver disease (28.2%) 44 patients had intestinal tuberculosis (21.8%) 18 patients had intestinal lymphoma (8.9%) 30 patients had GI malignancy (14.9%) and 53 patients had others gastrointestinal disorders (26.2%). Prevalence of malnutrition during hospital admission was 32.7%. Out of 202 patients, 66 patients (32.7%) were found to be malnourished at 1st day of hospital admission whereas 83 patients (41.1%) were malnourished at the time of discharge. Lowest recorded BMI was 14.8 and highest was 28.4 (19.9 mean ± 2.9 SD) whereas lowest recorded MAC was 15 and highest MAC was 34 (22.8 mean ± 3.4SD) during hospital admission. 14% patients had very poor appetite. Out of 145 patients who were hospitalized  for 14 days or less, 34 (23.4%) and 32 (22.1%) patients had significant decreased MAC and BMI respectively. Out of 57 patients admitted for more than 14 days, 24 patients (42.1%) had significant decrease in BMI whereas 14 patients (24.6%) had significant decrease in MAC. Conclusion: Nutritional status of the patients during hospital stay has changed significantly in relation to disease pattern JCMCTA 2020 ; 31 (1) : 19-25

Arsenic is a potent environmental toxicant and human carcinogen. Skin lesions are the most common manifestations of chronic exposure to arsenic. Advanced-stage skin lesions, particularly hyperkeratosis have been recognized as precancerous diseases. However, the underlying mechanism of arsenic-induced skin lesions remains unknown. Periostin, a matricellular protein, is implicated in the pathogenesis of many forms of skin lesions. The objective of this study was to examine whether periostin is associated with arsenic-induced skin lesions. A total of 442 individuals from low- (n = 123) and high-arsenic exposure areas (n = 319) in rural Bangladesh were evaluated for the presence of arsenic-induced skin lesions (Yes/No). Participants with skin lesions were further categorized into two groups: early-stage skin lesions (melanosis and keratosis) and advanced-stage skin lesions (hyperkeratosis). Drinking water, hair, and nail arsenic concentrations were considered as the participants’ exposure levels. The higher levels of arsenic and serum periostin were significantly associated with skin lesions. Causal mediation analysis revealed the significant effect of arsenic on skin lesions through the mediator, periostin, suggesting that periostin contributes to the development of skin lesions. When skin lesion was used as a three-category outcome (none, early-stage, and advanced-stage skin lesions), higher serum periostin levels were significantly associated with both early-stage and advanced-stage skin lesions. Median (IQR) periostin levels were progressively increased with the increasing severity of skin lesions. Furthermore, there were general trends in increasing serum type 2 cytokines (IL-4, IL-5, IL-13, and eotaxin) and immunoglobulin E (IgE) levels with the progression of the disease. The median (IQR) of IL-4, IL-5, IL-13, eotaxin, and IgE levels were significantly higher in the early-and advanced-stage skin lesions compared to the group of participants without skin lesions. The results of this study suggest that periostin is implicated in the pathogenesis and progression of arsenic-induced skin lesions through the dysregulation of type 2 immune response.

Carcinoma pancreas is the fourth common cause of the death from cancer in man and women in USA. The condition becomes increasingly common over the age of 70 years. The total number of carcinoma pancreas patients available for the study within the stipulated time was 22. Among them 68.18% patients were male and 31.82% patients were female. 0% belonged to age group ≤ 20, 9.09% belonged to age group 21-30, 18.18% belonged to age group 31-40, 18.18% belonged to age group 41-50, 13.64% belonged to age group 51-60, 27.27% belonged to age group 61-70 and 13.64% patients were >70 years of age. Mean age was 54.87 years ± 17.65 SD. In our study, 46.7% survived ≤3 months, 33.3% 4-6 months, 13.3% 7-9 months, 06.7% 10-12 months, 0% 13-24 months and >24 months. Among 15 expired patients, 02 got curative treatment and rest of 13 got palliative treatment. Those who got curative treatment, 50% survived 7-9 months and 50% 10-12 months. Those who got palliative treatment 53.8% survived ≤3 months, 38.5% 4-6 months and 7.7% 7-9 months. Overall median survival was 04 months, for curative treatment was 09 months and for palliative treatment was 03 months. TAJ 2020; 33(1): 11-16