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This study investigates the impact of business environment obstacles on the performance of Cottage, Micro, Small, and Medium Enterprises (CMSMEs) in Bangladesh, utilizing data from 998 firms in the 2022 World Bank Enterprise Survey. A recursive feature elimination algorithm identified ten key business factors and obstacles from an initial set of twenty-eight that significantly influence CMSME performance. Analysis using ordinary least squares (OLS) and generalized least squares (GLS) regression models reveals that investments in electricity infrastructure, access to financial services, and obtaining quality certifications positively impact CMSME performance. In contrast, challenges such as power outages, delays in licensing, uncompetitive practices, and stringent tax and labor regulations hinder performance. Additionally, the predictive accuracy of the OLS model was compared with several machine learning algorithms, including decision tree, random forest, support vector, and gradient boosting, using a 75-25 training-testing split and k-fold cross-validation. The findings provide data driven actionable insights for policymakers to address specific obstacles, thereby enhancing the business environment for CMSMEs in Bangladesh.

Objectives: Dengue emerged as a significant health threat in endemic regions in recent years. However, inconsistent diagnostic accuracy in sequential dengue infections necessitate improved testing methods to ensure effective management of dengue cases. Here, we evaluated a portable, rapid, and sensitive molecular assay—reverse transcriptase recombinase polymerase amplification assay (RT-RAA)—utilizing a mobile suitcase laboratory to detect infections in suspected dengue cases in Bangladesh. Methods: A total of 364 suspected patients with dengue were enrolled in the study. Dengue cases were confirmed by a positive result from any of the four tests: non-structural protein 1 (NS1) rapid diagnostic test (RDT), immunoglobulin (Ig) M RDT, quantitative reverse transcriptive-polymerase chain reaction (RT-PCR), and RT-RAA assay. IgG RDT was performed to differentiate between primary and secondary dengue infections. Results: Of 364 suspected cases, 320 were confirmed dengue cases, with 55.94% classified as primary and 44.06% as secondary infections. Laboratory results showed comparable positivity rates between RT-RAA (78.8%) and NS1 RDT (77.1%) in primary dengue, followed by quantitative RT-PCR (57.5%) and IgM RDT (12.8%). RT-RAA demonstrated superior positivity rates in secondary dengue (76.6%), surpassing RT-PCR (60.3%), NS1 RDT (27%), and IgM RDT (24.8%). Combining RT-RAA with NS1 RDT detected infections in 89.95% primary and 81.56% secondary dengue. Conclusions: The findings suggest that complementing RT-RAA with NS1 RDT could significantly improve dengue detection rate, particularly, for secondary infections.

BACKGROUND: Primary immunodeficiency diseases (PIDDs) are clinically and immunologically diverse and require a wide array of clinical and laboratory modalities to make specific diagnosis. Serum immunoglobulin levels and T cell, B cell and NK (Natural killer) cell immunophenotyping are routine laboratory investigations advised to diagnose the PIDD cases in Bangladesh. Along with T-B-NK markers, use of Naïve (CD45RA+) and memory (CD45RO+) T cell, switched memory B cell (CD27+IgD-) markers, detection of intracellular BTK (Bruton’s tyrosine kinase), LRBA (Lipopolysaccharide-responsive beige-like anchor), DOCK8 (Dedicator of cytokinesis 8) protein expression and DHR123 (Dihydro-rhodamine 123) assay of neutrophil can increase the PIDD cases detection in Bangladesh. METHODS: The study was conducted in the Department of Microbiology and Immunology, Bangabandhu Sheikh Mujib Medical University (BSMMU) during the time period of March, 2021 to February, 2022. Seventy clinically suspected PIDD cases were enrolled in this study on the basis of clinical findings and peripheral venous blood was collected from all patients to perform immunophenotyping. Routine T-B-NK cell, naïve and memory T cell with switched memory B cell markers were detected by flow-cytometry. Serum immunoglobulins (IgG, IgM, IgA & IgE) were estimated by Nephelometry and by Chemiluminescence. Intracellular BTK, LRBA and DOCK8 protein expression was detected by flow-cytometry in suspected X-linked agammaglobulinemia (XLA), LRBA and DOCK8 deficiency patients respectively. DHR123 assay was performed in suspected Chronic granulomatous disease (CGD) patients. RESULTS: Among the 70 clinically suspected PIDD cases, 9 (12.9%) were diagnosed as patients of PIDDs on the basis of laboratory evidence. Five (55.55%) cases were diagnosed as predominantly antibody deficiencies (PADs), 3 (33.33%) were patients of combined immunodeficiency (CID) and 1 (11.11%) was CGD patient. Among the diagnosed PIDD cases, 2 (22.22%) were diagnosed by T-B-NK cell immunophenotyping with serum immunoglobulin levels and 7 (77.77%) cases were diagnosed by additional CD45RA+, CD45RO+, CD27+IgD- markers, BTK protein expression detection and DHR123 assay. LRBA and DOCK8 deficiency cases could not found in this study. CONCLUSION: The use of additional markers (CD45RA+, CD45RO+, CD27+IgD-) with BTK, LRBA, DOCK8 intracellular protein expression evaluation and DHR123 assay by flow-cytometry can increase rate of specific diagnosis of the PIDD cases in Bangladeshi paediatric population.

This study examines the influence of women’s representation in top management positions and availability of skilled human capital on firm performance in Bangladesh, a critical aspect that remains underexplored in the existing literature. We leverage a fresh and comprehensive dataset of 824 firms released by the World Bank Enterprise Survey in 2023 and employ both traditional ordinary least squares (OLS) regression and machine learning algorithms to analyze the relationship. While the presence of female leadership alone may not substantially boost firm performance, our findings underscore a notable positive influence of women in leadership roles, contingent upon the presence of a skilled workforce. Notably, factors such as labor and electricity costs, access to financial resources, and international quality certification consistently show positive associations with firm performance. Our findings offer valuable guidance to policymakers and corporate decision-makers, highlighting the importance of supporting women in leadership roles while simultaneously investing in a skilled labor force to unlock firm productivity and success.

X-linked agammaglobulinemia (XLA) is a rare hereditary primary immunodeficiency disorder caused by mutation in the Bruton's tyrosine kinase (BTK) gene located in the Xq22 region of the X chromosome. It is characterized by absolute or marked deficiency of matured B-cells in circulation as well as decreased in all immunoglobulin (Ig) classes. We have reported one case who is a 48-month-old boy and suffering from recurrent pneumonia, skin abscess, otitis media, and swelling of the left knee joint. His serum Ig levels showed an IgM level of

The main purpose of this article is to investigate the impact of economic growth, foreign direct investment (FDI), and trade openness (TO), and the Asian and global financial crisis on environmental quality based on the environmental Kuznets curve (EKC) hypothesis on panel data of 32 Asian economies over the 1991–2019 period. Our study supports the EKC hypothesis, implying that economic growth increases emissions to a certain point, after which growth helps reduce carbon emissions. By employing several panel data econometric estimation techniques (such as ordinary least squares, fixed effects models, and difference-generalized method of moments estimations), the study also shows robust findings that FDI could reduce carbon emissions in the Asian region by welcoming environmentally friendly technology and know-how into the economy. However, though the study finds that financial crises reduce emissions in Asian countries, the increase of TO in this region leads to an increase in emissions and causes of environmental degradation. Thus, to ensure environmental sustainability, Asian policymakers should formulate lucrative policies to attract FDI, and trade policies should also be revised.

Purpose ― The main objective of this study is to develop a comprehensive digital financial inclusion index (CDFII) that accounts for technology-driven financial inclusion and to compare it with a traditional financial inclusion index (TFII) to enhance the measurement of fintech-driven financial inclusion across countries. Methods ― The study employs a three-stage principal component analysis (PCA) to construct the CDFII and TFII using the latest available data from 31 developing countries during the period 2015-2021. The CDFII incorporates a new sub-index measuring individual literacy levels for using financial services, along with existing sub-indices capturing the penetration, availability, and usage of DFS. By integrating digital financial inclusion (DFII) and TFII, the overall CDFII is estimated. Findings ― The findings reveal that the levels of DFII and CDFII are higher than TFII for most of the economies examined. This indicates the significant impact of technology-driven financial inclusion in expanding access to formal banking and non-banking financial services for previously unbanked populations. Implication ― The study implies that policymakers and researchers should prioritize the integration of technology-driven financial inclusion indicators, such as the comprehensive digital financial inclusion index (CDFII), into their assessments and interventions to ensure a more accurate and effective approach to promoting inclusive and sustainable economic development. Originality ― This study introduces the CDFII as a novel comprehensive index that addresses the shortcomings of traditional financial inclusion indices. By incorporating individual skill levels and considering dimensions specific to DFS, the CDFII provides a more accurate representation of fintech-driven financial inclusion levels. This contributes to the existing literature on financial inclusion measurement and provides a valuable analytical tool for researchers and policymakers.

Purpose – Exchange rate uncertainty leads to an indecisive environment for imports and exports that would condense international trade, foreign direct investment, trade earnings, trade volumes, economic growth and welfare. This study aims to examine, empirically, the effect of exchange rate uncertainty on bilateral trade performance, focusing on eight SAARC member economies using the popular modified gravity model of trade. Design/methodology/approach – The paper includes eight SAARC members – Afghanistan, Bangladesh, Bhutan, Maldives, Nepal, Pakistan and Sri Lanka panel data set over the period 2005–2018. The authors consider both standardized value (standard deviation) and conditional variance model to determine volatility of exchange rate. Primarily, ordinary least squares, random effects and fixed effects estimation techniques are employed to investigate the impact of exchange rate volatility. Endogeneity and robustness of the findings have been tested using the simultaneity-adjusted model and dynamic panel data two-step system GMM estimation techniques. Findings – Empirical findings endorse the view that exchange rate volatility lowers trade flows in the SAARC regions. However, this adverse effect of exchange rate uncertainty on trade is pretty small. The negative correlation between exchange rate volatility and bilateral trade remains consistent and significant after controlling of simultaneous causality, autocorrelation, year effects, country-pair heterogeneity and endogeneity irrespective of panel data estimation techniques and different measures of volatility. Originality/value – The present paper is original work.

Background: Urinary tract infection (UTI) remains one of the most common and major complications after renal transplantation. Objective: The study was undertaken to get an insight regarding the bacterial pathogen which is responsible for UTI in post renal transplant patients and their risk factors association. Methods: This was an observational study, conducted in the Department of Microbiology and Immunology Bangabandhu Sheikh Mujib Medical University (BSMMU) from December 2010 to December 2011. Twenty- one renal transplant recipients were evaluated for UTl after surgery up to six weeks. Microscopic examination and culture of urine were performed in every pre-transplant period, 3rd POD, 7th POD, within six weeks and as per patient's clinical condition. UTI was considered when bacterial count was

Background: Tuberculosis (TB) remains one of the major causes of death from a single infectious agent worldwide. The early detection of new cases of pulmonary tuberculosis is an important goal in tuberculosis control program. Objective: 1n this study, thin layer agar (TLA) culture was compared with Lowenstein-Jensen (LJ) culture for rapid detection of pulmonary tuberculosis. Methods: It was a cross sectional study conducted in National Tuberculosis Reference Labora­tory (NTRL) of National Institute of Disease of Chest and Hospital (NIDCH), Dhaka, from July 2010 to June 2011. A total of 100 sputum smear positive for acid fast bacilli (AFB) by Z-N staining, pulmonary tuberculosis patients were included in this study. Samples were processed by modified Petroff method and then cultured on thin layer 7H11(TL7H11) plates and L-J tubes. TL7H11 plates were observed microscopically for rnicrocolony growth once a week for 6 weeks, and L-J tubes were observed once a week for 8 weeks. Results: The recovery rates of mycobacteria on only TLA, only LJ and on both media were 90%, 97% and 88% respectively. Overall positivity was 99% in both L-J and TLA media. Mean time for detection of mycobacteria on TLA was 9.04±1.66 days compared to 21.78±6.19 days on L-J media. The rate of contamination was higher (6%) in L-J media than in TLA media (4%). Conclusion: The TL7H11 media can be used as an alternative to the Lowenstein-Jensen medium for early isolation of mycobacteria in resource constrained settings.

Background: Neonatal septicemia is one of the major health problems throughout the world. Infections are a frequent and important cause of morbidity and mortality in neonatal period. Objective: The objective of this study was the role of hematologic scoring system (HSS) in the early diagnosis of neonatal septicemia. Methods: This is a prospective study consisted of 100 neonates admitted at neonatal ICU, BSMMU, who were clinically suspected cases of septicemia. The neonatal hematological parameter was measured in all cases. Blood culture was done for the gold standard of proven sepsis. There were 12 out of 100 neonates (12%) who had culture proven sepsis. They were predominantly preterm and of very low birth weight. Results: On evaluation of various hematological parameters total leucocytes count, total neutrophil count, IT ratio (>0.2), IM ratio (> 0.3), total immature PMNs count, platelet count were found to have optimal sensitivities and negative predictive values. Using these values hematologic scoring system was formulated according to Rodwell et al. Score > 4 has a sensitivity of 100%, specificity of 60%, with PPV 26% and NPV 100 %. Considering the high sensitivity, negative predictive value, this study implies that score > 4 were more reliable as a screening tool for sepsis than any of the individual hematological parameter. Conclusion: HSS are useful test to distinguish the infected from non infected infants. They also provide a effective guideline to make decisions regarding judicious use of antibiotic therapy. Keywords: Hematologic scoring system (HSS); Blood culture; Neonatal septicemia DOI: 10.3329/bsmmuj.v3i2.7053 BSMMU J 2010; 3(2): 62-67