The endothelial glycocalyx (EG) is the thin sugar-based lining on the apical surface of endothelial cells. It has been linked to the physiological functioning of the microcirculation and has been found to be damaged in critical illness and after acute care surgery. This review aims to describe the role of EG in severely injured patients undergoing surgery, discuss specific situations (e.G.majortrauma, hemorrhagic shock, trauma induced coagulopathy) as well as specific interventions commonly applied in these patients (e.g. fluid therapy, transfusion) and specific drugs related to perioperative medicine with regard to their impact on EG.EG in acute care surgery is exposed to damage due to tissue trauma, inflammation, oxidative stress and inadequate fluid therapy. Even though some interventions (transfusion of plasma, human serum albumin, hydrocortisone, sevoflurane) are described as potentially EG protective there is still no specific treatment for EG protection and recovery in clinical medicine.The most important principle to be adopted in routine clinical practice at present is to acknowledge the fragile structure of the EG and avoid further damage which is potentially related to worsened clinical outcome.

To examine whether PHGG added ORS reduce duration of diarrhoea, stool output and enhance weight gain. In a double-blind controlled clinical trial, 126 malnourished children (weight for length/weight for age < −3 Z-score with or without pedal edema), aged 6 – 36 months with acute diarrhoea <7 days were studied in two treatment groups; 63 received modified WHO ORS (Na 75, K 40, Cl 87, citrate 7, glucose 90 mmol/L) with PHGG 15 g/L (study group); 63 received modified WHO ORS without PHGG (control). Other treatments were similar in both groups. The study protocol was approved by Ethics Committee of icddr,b; the study was carried out at the Dhaka Hospital. The mean duration of diarrhoea (h) was significantly shorter in children of the study group (Study vs. control, mean ± SD, 57 ± 31 vs. 75 ± 39, p = 0.01). Although there was a trend in stool weight reduction in children receiving ORS with PHGG (study vs. control, stool weight (g), mean ± SD; 1st 24 hour, 854.03 ± 532.15 vs. 949.11 ± 544.33, p = 0.32; 2nd 24 hour, 579.84 ± 466.01 vs. 761.26 ± 631.64, p = 0.069; 3rd 24 hour, 385.87 ± 454.09 vs. 495.73 ± 487.61, p = 0.196), especially in 2nd 24 h period, the difference was not statistically significant. The mean time (day) to attain weight for length 80% of NCHS median without edema was significantly shorter in the study group (study vs. control, mean ± SD, 4.5 ± 2.6 vs. 5.7 ± 2.8, p = 0.027). PHGG added to ORS substantially reduced duration of diarrhoea. It also enhanced weight gain. Further studies might substantiate to establish its beneficial effect. NCT01821586

The novel coronavirus has become a global risk because of its massive transmission and high rates of mutation. Efficient clinical management remains a challenge in combatting the severe acute respiratory syndrome caused by this virulent strain. This contagious disease is new to the people of Bangladesh. The country is at high risk of spreading the coronavirus infection particularly because of its high population density. Significant morbidity and mortality have been observed for the quick transmission of this virus since March 8, 2020. The basic objective of this article is to analyze the preparedness of Bangladesh, given its constraints and limitations, to cope with the rapid spread of COVID-19 infection. In doing so, it summarizes the origin of coronavirus, epidemiology, mode of transmission, diagnosis, treatment, prevention and control of the disease. Although many steps have been taken by the Government and the private sector of Bangladesh to create awareness about measures needed to prevent the deadly infections, many people are unaware of and reluctant to accept the prescribed rules. Inadequacy of diagnostic facilities and limitations of clinical care and health care services were major constraints faced in treating COVID-19 infected people in Bangladesh. Greater compliance by the people in following the suggested measures may help reduce the rapid spread of the disease and overcome the challenges faced by this pandemic.

BACKGROUND: Microvascular dysfunction is a main contributor to morbidity and mortality worldwide. Sophisticated technical tools (e.g. miniaturizedhardware, automated software), along with skilled personnelare the prerequisite for quantitative observa

Pneumonia represents one of the major infectious diseases in developing countries and is associated with high mortality, in particular in children under the age of five. The main causative bacterial agents are Streptococcus pneumoniae and Haemophilus influenzae type B, accounting for 33% and 16%, respectively, of the mortality in under-fives. Iron modulates the immune response in infectious diseases and increased iron levels can lead to complications such as sepsis and multiorgan failure. This review will look into the use of iron chelators in order to reduce microbial growth and attenuate a dysregulated immune response during infection. Our hypothesis is that temporary restriction of iron will lessen the incidence and complication rate of infections like pneumonia and result in a decrease of mortality and morbidity.