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Background: Global incidence of dengue has increased dramatically over the last few decades. In Bangladesh, there is a high transmission of Dengue in urban and peri-urban areas of Dhaka and other major cities. Seasonal variation, improper surveillance, underreporting of dengue infection have made difficult to estimate disease burden of dengue. Objective: This study was aimed to observe the rate of seropositivity by ELISA for Dengue IgG patients presenting to hospital. Methods: This is a cross-sectional study done in seven medical college hospital in urban Dhaka from January 2018 to March 2018. A small amount of blood was taken obtaining informed written consent in patients selected by purposive sampling during presenting to hospitals and a pre-tested questionnaire was fill to gather socio-demographic and relevant epidemiological data. Results: A total of 695 patients were included in this study with a mean age 34.9±16.49. Dengue IgG was positive in 349 (51.2%), positivity was found highest (70%) in Shahabuddin Medical College Hospital and lowest (25%) in Uttara Adhunik Medical College. Dengue IgG positive patients were more literate (82% vs 74.2%), more from urban setting (51.2% vs 41.8%), had more monthly income, had more garden (26.8% vs 23.3%) and stagnant water (25.5% vs 23%) in comparison to IgG negative patients. Conclusion: This study revealed that high seroprevalence posing risk to develop severe dengue and indicating high disease burden which warranted large scale well design population-based study. Bangladesh Med Res Counc Bull 2021; 47(1): 17-22

Objectives The study aims to explore the existing pattern of mental healthcare-seeking behavior among the adult population in Bangladesh, and to delineate the factors that influence the mental health patients' decision to receive mental healthcare services.Methods We used the National Mental Health Survey Bangladesh 2019 dataset with 7270 households to identify the patterns and catalysts of seeking mental health care services. A Probit model using a standard normal cumulative distribution function (CDF) with three specifications has been applied to identify the factors influencing mental healthcare-seeking behavior and the probability of seeking mental healthcare services in Bangladesh.Results We found that about 19% of the total adult population have mental health disorder in the country. Among the mental health disorder patients, only 10% seek healthcare services from different sources of mental healthcare services. Patients with addictive disorder show the lowest interest in seeking healthcare services, while patients with bipolar-related disorder receive treatment from mental healthcare sources. Findings portray that 4.8% of addictive disorder patients seek healthcare services. On the other hand, 34.4% of bipolar-related disorder patients receive treatment for mental health. In addition, the findings from the Probit model show that only the existence of other mentally disordered family members is the only statistically significant determinant among the socio-economic factors, such as gender, age, religion, education level and residential status. The marginal effects analysis shows that the existence of mentally disordered family members increases the probability of seeking mental health care services by around 6%. The other socio-economic variables considered in the study are found statistically insignificant. However, a married woman has a significantly higher likelihood of seeking treatment than an unmarried woman, while the family size is the only variable that significantly influences treatment-seeking behavior for men.Conclusion Though mental health conditions are major public health concerns in Bangladesh, the treatment-seeking behavior among the mentally diorder people is very low, implying a large treatment gap in the mental health sector. The findings indicate the urgent need to increase mental health service coverage among mental health patients.

Introduction: Copy number variations (CNVs) play a critical role in the pathogenesis of neurodevelopmental disorders (NDD) among children. In this study, we aim to identify clinically relevant CNVs, genes and their phenotypic characteristics in an ethnically underrepresented homogenous population of Bangladesh.Methods: We have conducted chromosomal microarray analysis (CMA) for 212 NDD patients with male to female ratio of 2.2:1.0 to identify rare CNVs. To identify candidate genes within the rare CNVs, gene constraint metrics [i.e., “Critical-Exon Genes (CEGs)”] were applied to the population data. Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) was followed in a subset of 95 NDD patients to assess the severity of autism and all statistical tests were performed using the R package.Results: Of all the samples assayed, 12.26% (26/212) and 57.08% (121/212) patients carried pathogenic and variant of uncertain significance (VOUS) CNVs, respectively. While 2.83% (6/212) patients’ pathogenic CNVs were found to be located in the subtelomeric regions. Further burden test identified females are significant carriers of pathogenic CNVs compared to males (OR = 4.2; p = 0.0007). We have observed an increased number of Loss of heterozygosity (LOH) within cases with 23.85% (26/109) consanguineous parents. Our analyses on imprinting genes show, 36 LOH variants disrupting 69 unique imprinted genes and classified these variants as VOUS. ADOS-2 subset shows severe social communication deficit (p = 0.014) and overall ASD symptoms severity (p = 0.026) among the patients carrying duplication CNV compared to the CNV negative group. Candidate gene analysis identified 153 unique CEGs in pathogenic CNVs and 31 in VOUS. Of the unique genes, 18 genes were found to be in smaller (PSMC3 gene as a strong candidate gene for Autism Spectrum Disorder (ASD). Moreover, we hypothesized that KMT2B gene duplication might be associated with intellectual disability.Conclusion: Our results show the utility of CMA for precise genetic diagnosis and its integration into the diagnosis, therapy and management of NDD patients.

Background: A limited number of studies have exclusively assessed fatigue among post-COVID patients. Our study aimed to assess the persistence and associations of fatigue among COVID-19 survivors after two months of recovery from their primary illness. Methods: During hospital admission from August to September, 2020, a total of 400 patients were diagnosed to be suffering from fatigue using Chalder fatigue scale. After obtaining informed written consent, patients were followed up two months later over telephone. A total of 332 participants participated in the interview (63 patients could not be traced and another 5 patient died within two months). Patients were asked to categorize their present fatigue condition based on a simplified questionnaire developed for telephone interview. Results: Among study participants, 62.9% (n=207) were found to be still suffering from fatigue two months after their hospital discharge. A significant association of fatigue was found with age (p=0.000), hypertension (RR: 1.51; CI: 1.15-1.99; p=0.002), diabetes mellitus (RR: 1.45; CI: 1.08-1.95; p=0.010), ischemic heart disease (RR: 2.04; CI: 1.15-3.64; p=0.011), on admission SpO2 (p=0.000), on admission serum ferritin (p=0.000), d-dimer (p=0.000), CRP (p=0.000), and Hb% (p=0.019). Binary logistic regression model revealed significant association of age and onadmission SpO2 with persistence of fatigue. Conclusions: Fatigue is a highly prevalent symptom among the COVID-19 survivors with significant association between fatigue and patients clinical and laboratory markers. Bangladesh J Medicine July 2022; 33(1) : 57-63

BackgroundDiagnosis of visceral leishmaniasis (VL) through the detection of its causative agents namely Leishmania donovani and L. infantum is traditionally based on Giemsa-stained smears of bone marrow, spleen aspirates, liver or lymph node. Collection of these samples involve invasive procedures and carries the risk of fatal hemorrhage especially during splenic aspiration. Earlier, we reported a Polymerase Chain Reaction (PCR)-based diagnosis of L. donovani in peripheral blood using a novel set of PCR primers with absolute specificity (Khatun et al. 2017). Using the same set of primers and PCR conditions, here we describe diagnosis of L. donovani from urine, for a non-invasive, rapid and safe diagnosis.MethodsDiagnosis of L. donovani was carried out using urine samples collected from clinically diagnosed VL patients (n=23) of Bangladesh in Real Time PCR. Test results were validated by comparing blood samples from the same set of patients. Sensitivity and specificity of this diagnosis was analyzed using retrospective bone marrow samples, collected earlier from confirmed VL patients (n=19) (Khatun et al. 2017).ResultsThe method showed 100% sensitivity in detecting VL in urine and corresponding blood samples and bone marrow samples, as well as 100% specificity in control groups.ConclusionUrine-based diagnosis could be a patient-friendly, non-invasive approach for VL detection with precision and perfection.

Background: Dengue fever is endemic in Bangladesh. Its incidence has been increasing and spreadingfrom urban Dhaka to rural areas. In 2019, over 100,000 cases reported with deaths over 250.Clinical profiles varied from classical signs and symptoms to alarming severity and complications,such as, Expanded Dengue Syndrome (EDS), Dengue Shock Syndrome (DSS) along with coinfectionsand comorbidities. No detail study on EDS & DSS carried out yet over 2019 outbreak. This reporthighlights the features, management and the outcome of EDS & DSS cases of 2018-19 admitted in aspecialized tertiary private hospital in Dhaka, Bangladesh. Methods: This cross sectional observational study was performed at Square Hospital, Dhaka,exclusively over 62 adult dengue patients with complications who fulfilled the admission criteria inICU and HDU and managed as per national guidelines and diagnosed by positive NS1 Ag, DengueRT PCR , Anti-dengue IgM, hematological and biochemical tests. Results: Of 343 cases, 62 (18.1%) patients had complications; 17 (27.4%) admitted in ICU and 45(72.6%) patients in HDU. Among 62 patients, 25 patients had EDS (40.3%) and 17 had DSS (27.4%).Of the EDS patients, majority were 40-50 years old with male predominance. Of 62 patients, 42 hadatypical presentations (67.74%), 25 (40.3%) had EDS and 17 (27.4%) had DSS, 16 (25.8%) had coinfection,45 (72.58%) had co-morbidities. Most patients presented with gastrointestinal symptoms(80%). Twenty one cases (84%) of EDS survive; 4 (16%), died after developing rhabdomyolysis, multiorgandysfunction and acute renal failure. Conclusion: Early diagnosis of complicated cases by clinical features, lab predictors and early fluidtherapy are the key to successful management with positive outcome. Death could be averted byrecognizing the stage of plasma leakage indicated by raised CRP, reduced serum Albumin, andultrasonography for detecting ascites, pleural effusion, mucosal thickening and edema of gall bladderand appropriate replacement of fluid loss and maintenance of nutrition. Bangladesh J Medicine July 2020; 31(2) :58-63

There is increasing evidence of the post-COVID-19 suffering and decreased quality of life in the COVID-19 patients. This study aimed to assess the quality of life and associated factors of COVID-19 patients at one month after discharge from the hospital. This was a cross-sectional study that was conducted at the post-covid clinic of Dhaka Medical College Hospital (DMCH) where RT–PCR-confirmed adult COVID-19 recovered patients were enrolled one month after discharge from the same hospital. They were consecutively selected from January 01 to May 30. A pretested semi-structured questionnaire was used for the data collection for clinical variables. The generic multi-attributable utility instrument EQ-5D-5L was used for assessing health-related quality of life (HRQoL). A total of 563 patients were enrolled in the study. The patients had a mean age with standard deviation (±SD) of 51.18 (±13.49) years and 55.95% were male. The mean (SD) EQ-5D-5L index score and EQ-VAS scores were 0.78 (±0.19) and 70.26 (±11.13), respectively. Overall, 45.77%, 50.99%, 52.79%, 55.14% and 62.16% had problems (slight to extreme) in the mobility, self-care, usual activities, pain/discomfort and anxiety/depression dimensions, respectively. Patients aged ≥60 years had significant problem in mobility (odds ratio [OR] 3.24, 95% confidence interval [CI]: 1.07–9.77). Female participants were 5.50 times (95% CI: 2.22–13.62) more likely to have problems in their usual activities. In comparison to urban area, living in a peri-urban setting was significantly associated with problems in mobility (OR 1.89, 95% CI: 1.13–3.20), pain/discomfort (OR 1.82, 95% CI: 1.04–3.12) and anxiety/depression (OR 2.16, 95% CI: 1.22–3.84). Comorbid patients were 1.75 times (95% CI: 1.07–2.85) more likely to report problems in the pain/discomfort dimension. Presence of symptom(s) was associated with problems in self-care (OR 3.27, 95%CI: 1.31–8.18), usual-activity (OR 3.08, 95%CI: 1.21–7.87), pain/discomfort dimensions (OR 2.75, 95%CI: 1.09–6.96) and anxiety/depression (OR 3.35, 95%CI: 1.35–8.30). Specific management strategies should be planned to address the factors associated with low health-related quality of life in post-acute care of COVID-19 patients.

Chronic diseases, including non-communicable diseases (NCDs), have arisen as a severe threat to health and socio-economic growth. Telemedicine can provide both the highest level of patient satisfaction and the lowest risk of infection during a pandemic. The factors associated with its usage and patient adherence are not visible in Bangladesh’s resource-constrained settings. Therefore, this study aimed to identify perceptions about telemedicine among populations with chronic diseases amid the COVID-19 pandemic. A closed-ended self-reported questionnaire was created, and the questionnaire was written, reviewed, and finalized by a public health investigator, a psychiatrist, and an epidemiologist. The data for this study were collected from individuals using simple random sampling and snowball sampling techniques. Ethics approval was granted, and written/verbal consent was taken before interviews. Most of the participants showed a positive attitude towards telemedicine. People aged 35–54 years old and a higher level of education were less frequently associated with willingness to receive telemedicine services for current chronic disease (WRTCCD) than their counterparts. People living in urban areas and lower-income participants were more strongly associated with WRTCCD. Additionally, people who did not lose their earnings due to the pandemic were less strongly associated with WRTCCD. However, the main strength of this research is that it is a broad exploration of patient interest in several general forms of telehealth. In Bangladesh, there are many opportunities for telemedicine to be integrated into the existing healthcare system, if appropriate training and education are provided for healthcare professionals.

Background and aims Dyspnea is one of the most common symptoms associated with the COVID‐19 caused by novel coronavirus SARS‐CoV‐2. This study aimed to assess the prevalence of dyspnea, observe co‐variables, and find predictors of dyspnea after 2 months of recovery from COVID‐19. Methods A total of 377 patients were included in the study based on their responses and clinical findings during initial admission to the hospital with COVID‐19. After excluding five deceased patients, a total of 327 patients were interviewed through telephone using a 12‐point dyspnea scale and using relevant questions to gauge the patient clinically. Interviews were carried out by trained physicians, and responses were recorded and stored. All analyses were carried out using the statistical programming language R. Results Of the total 327 participants in the study, 34% had stated that they were suffering from respiratory symptoms even after 2 months of COVID‐19. The study demonstrated that patient oxygen saturation level SpO2 (P = .03), D‐dimer (P = .001), serum ferritin (P = .006), and the presence and severity of dyspnea are significantly correlated. In addition to that, patient smoking history (P = .012) and comorbidities such as chronic obstructive pulmonary disease (COPD) (P = .021) were found to be statistically significant among groups. Conclusion These findings of this study can be useful for predicting and managing long‐term complications of COVID‐19.

Background: Copy number variations (CNVs) play a critical role into the pathogenesis of neurodevelopmental disorders (NDD) among children. In this study, we aim to identify clinically relevant CNVs, genes and their phenotypic characteristics in an ethnically underrepresented homogenous population of Bangladesh. Methods: We have conducted genome-wide chromosomal microarray analysis (CMA) for 212 NDD patients with male to female ratio of 2.2:1.0 to identify rare chromosomal abnormalities (deletion /duplication/ rearrangements). To identify candidate genes within the rare CNVs, multiple gene constraint metrics (i.e. “Critical-Exon Genes (CEGs)”) were applied to the population data. Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) was followed in a subset of 95 NDD patients to assess the severity of autism and all statistical tests were performed using R package. Results: In our cohort, the head circumference of males are significantly greater than females (p=0.0002). Of all samples assayed, 12.26% (26/212) and 47.17% (100/212) patients carried pathogenic and variant of uncertain significance (VOUS) CNVs, respectively. 2.83% (6/212) pathogenic CNVs are located at the subtelomeric regions. Further burden test identified females are significant carriers of pathogenic CNVs in comparison to males (OR=4.2; p=0.0007). ADOS-2 subset show severe social communication deficit (p=0.014) and overall ASD symptoms severity (p=0.026) among the patients carrying duplication CNV compared to the CNV negative group. Candidate gene analysis identified 153 unique CEGs in pathogenic CNVs and 31 in VOUS. Of the unique genes, 18 genes were found to be in smaller (PSMC3 gene as a potential candidate gene for Autism Spectrum Disorder (ASD). Moreover, we hypothesized that KMT2B gene duplication might be associated with intellectual disability. Conclusion: Our results show the utility of CMA for precise genetic diagnosis and its integration into the diagnosis therapeutics and management of NDD patients.

Background: Hepatic malignancy is an important clinical condition which is associated with poor outcome. Clinicalassessment of a patient with hepatic malignancy is crucial to sort out the primary and secondary, and so biochemicaland radiological investigations are needed. Hence fine needle aspiration cytology (FNAC) of the lesion is essentialwhich is a minimal invasive procedure to combat a deadly disease. Objective: The aim of this prospective cross sectional observational study was clinical assessment of primary andsecondary hepatic malignancy and its co-relation with FNAC of hepatic malignancy. Methods: Patients admitted in Medicine Department, Dhaka medical College, with hepatic malignancy from January2013 to June 2014 and then confirmed by FNAC (USG guided) of liver mass were included in the study. A total 100patients were enrolled in the study in a non-random convenient sampling method. Result: In this study 42 patients were found having primary Hepatocellular Carcinoma (HCC) and 58 patients hadsecondary hepatic malignancy. FNAC confirmed secondary hepatic malignancy (n=58) as metastatic adenocarcinoma43(74.1%), metastatic small cell carcinoma 9(15.5%), Gastro Intestinal Stromal Tumour (GIST) 2(3.4%), squamouscell carcinoma 2(3.4%) & Non Hodgkins lymphoma 2(3.4%). Most of the patients of primary hepatic malignancybetween 20-40 years 18(42.9%) and secondary hepatic malignancy between 40-60 years 35(60.3%). Incidence in maleis more in both primary 31(73.8%) and secondary 38(65.5%) hepatic malignancy. Both HCC and secondariespredominantly presents with abdominal pain, 39(92.9%) cases of HCC and 47(81.0%) of secondaries. Incidence ofmultiple lesion in ultrasonogram is more in both primary 30(71.4%) and secondary 47(81.0%) hepatic malignancy.Positive HBsAg, Positive Anti HBc (total), Positive Anti HCV were found in 15(35.7%), 11(26.2%) and 9(21.4%) casesof HCC respectively. Positive Alpha Feto Protein (AFP) was found insignificant in this study. Conclusion: Fine Needle Aspiration (FNA) is a useful diagnostic test for evaluating patients with discrete hepaticmasses. Correlation with clinical, radiological and cytological findings is helpful in arriving at the correct diagnosisand therefore increases overall accuracy and cost-effectiveness of the procedure. Bangladesh Crit Care J September 2019; 7(2): 81-85

Diagnosis of visceral leishmaniasis (VL) through the detection of its causative agents namely Leishmania donovani and L. infantum is traditionally based on immunochromatographic tests, microscopy of bone marrow, spleen aspirates, liver or lymph node and differential diagnosis. While the first process has low specificity, the later one carries the risk of fatal hemorrhage. Over the last decade, multiple Polymerase Chain Reaction (PCR) based diagnosis has been developed using blood and urine sample with a varying degree of sensitivity and specificity, an issue worth improving for precision diagnosis. Earlier, we reported a PCR-based diagnosis of L. donovani in peripheral blood using a novel set of PCR primers with absolute specificity. Using the same set of primers and PCR conditions, here we describe diagnosis of L. donovani from urine, for a non-invasive, rapid and safe diagnosis. Diagnosis of VL was carried out using urine samples collected from clinically diagnosed VL patients (n = 23) of Bangladesh in Real Time PCR. Test results were validated by comparing blood samples from the same set of patients. Sensitivity and specificity of this diagnosis was analyzed using retrospective bone marrow samples, collected earlier from confirmed VL patients (n = 19). The method showed 100% sensitivity in detecting L. donovani in urine and corresponding blood and retrospective bone marrow samples, as well as 100% specificity in control groups. A Real Time PCR-based molecular detection system using urine sample is hereafter presented what could be a, non-invasive approach for VL detection with precision and perfection.

The clinical presentation of COVID-19 and the specific antibody responses associated with SARS-CoV-2 variants have not been investigated during the emergence of Omicron variants in Bangladesh. The Delta and Omicron variants were identified by post-PCR melting curve analysis of the spike (S) protein receptor binding domain amplicons. Anti-S-protein immunoglobulin-G anti-nucleocapsid (N)-protein immunoglobulin-G and immunoglobulin-A levels were measured by ELISA. The Delta variant was found in 40 out of 40 (100%) SARS-CoV-2 RT-PCR positive COVID-19 patients between 13 September and 23 October 2021 and Omicron variants in 90 out of 90 (100%) RT-PCR positive COVID-19 patients between 9 January and 10 February 2022. The Delta variant associated with hospitalization (74%, 80%, and 40%) and oxygen support (60%, 57%, and 40%) in the no vaccine, dose-1, and dose-2 vaccinated cases, respectively, whereas the Omicron COVID-19 required neither hospitalization nor oxygen support (0%, p < 0.0001). Fever, cough, and breathlessness were found at a significantly higher frequency among the Delta than Omicron variants (p < 0.001). The viral RNA levels of the Delta variant were higher than that of the Omicron variants (Ct median 19.9 versus 23.85; p < 0.02). Anti-spike protein immunoglobulin-G and anti-N-protein immunoglobulin-G within 1 week post onset of Delta variant COVID-19 symptoms indicate prior SARS-CoV-2 infection. The Delta variant and Omicron BA.1 and BA.2 breakthrough infections in the Dhaka region, at 240 days post onset of COVID-19 symptoms, negatively correlated with the time interval between the second vaccine dose and serum sampling. The findings of lower anti-spike protein immunoglobulin-G reactivity after booster vaccination than after the second vaccine dose suggest that the booster vaccine is not necessarily beneficial in young Bangladeshi adults having a history of repeated SARS-CoV-2 infections.

The current study elucidated an association between gene variants and thrombocytopenia through the investigation of the exonic polymorphic landscape of hematopoietic transcription factor—GATA1 gene in dengue patients. A total of 115 unrelated dengue patients with dengue fever (DF) (N = 91) and dengue hemorrhagic fever (DHF) (N = 24) were included in the study. All dengue patients were confirmed through detection of NS1 antigen, IgM, and IgG antibodies against the dengue virus. Polymerase chain reaction using specific primers amplified the exonic regions of GATA1 while Sanger sequencing and chromatogram analyses facilitated the identification of variants. Variants G>A (at chX: 48792009) and C>A (at chX: 4879118) had higher frequency out of 13 variants identified (3 annotated and 10 newly recognized). Patients carrying either nonsynonymous or synonymous variants had significantly lower mean values of platelets compared to those harboring the reference nucleotides (NC_000023.11). Further analyses revealed that the change in amino acid residue leads to the altered three-dimensional structure followed by interaction with neighboring residues. Increased stability of the protein due to substitution of serine by asparagine (S129N at chX: 48792009) may cause increased rigidity followed by reduced structural flexibility which may ultimately disturb the dimerization (an important prerequisite for GATA1 to perform its biological activity) process of the GATA1 protein. This, in turn, may affect the function of GATA1 followed by impaired production of mature platelets which may be reflected by the lower platelet counts in individuals with such variation. In summary, we have identified new variants within the GATA1 gene which were found to be clinically relevant to the outcome of dengue patients and thus, have the potential as candidate biomarkers for the determination of severity and prognosis of thrombocytopenia caused by dengue virus. However, further validation of this study in a large number of dengue patients is warranted. Trial Registration: number SLCTR/2019/037.

not available Bangladesh J Medicine 2022; 33: 317

not available Bangladesh J Medicine July 2022; 33(1) : 126-127

not availableJ MEDICINE July 2017; 18 (2) : 92-108

Background Genetic testing is becoming an essential tool for breast cancer (BC) diagnosis and treatment pathway, and particularly important for early detection and cancer prevention. The purpose of this study was to explore the diagnostic yield of targeted sequencing of the high priority BC genes. Methods We have utilized a cost-effective targeted sequencing approach of high priority actionable BC genes (BRCA1, BRCA2, ERBB2 and TP53) in a homogeneous patient cohort from Bangladesh (n = 52) by using tumor and blood samples. Results Blood derived targeted sequencing revealed 25.58% (11/43) clinically relevant mutations (both pathogenic and variants of uncertain significance (VUS)), with 13.95% (6/43) of samples carrying a pathogenic mutations. We have identified and validated five novel pathogenic germline mutations in this cohort, comprising of two frameshift deletions in BRCA2, and missense mutations in BRCA1, BRCA2 and ERBB2 gene respectively. Furthermore, we have identified three pathogenic mutations and a VUS within three tumor samples, including a sample carrying pathogenic mutations impacting both TP53 (c.322dupG; a novel frameshift insertion) and BRCA1 genes (c.116G > A). 22% of tissue samples had a clinically relevant TP53 mutation. Although the cohort is small, we have found pathogenic mutations to be enriched in BRCA2 (9.30%, 4/43) compare to BRCA1 (4.65%, 2/43). The frequency of germline VUS mutations found to be similar in both BRCA1 (4.65%; 2/43) and BRCA2 (4.65%; 2/43) compared to ERBB2 (2.32%; 1/43). Conclusions This is the first genetic study of BC predisposition genes in this population, implies that genetic screening through targeted sequencing can detect clinically significant and actionable BC-relevant mutations. Electronic supplementary material The online version of this article (10.1186/s12881-019-0881-0) contains supplementary material, which is available to authorized users.

Melioidosis is known to occur in Bangladesh, but there are few reports about the condition in the published international literature. We set out to review all known cases of melioidosis in the country to date, using both retrospective and prospective data. A web-based literature search was conducted to identify all published case reports, original articles and conference abstracts. Cases were also included from a prospective study conducted in 2017. Fifty-one cases were identified between 1961 and 2017. Cases have been reported from sixteen out of the 64 districts of Bangladesh. The median age of the patients at presentation was 45 years (IQR 37–52), with a significant male (77%) predominance. Many patients (14/39; 36%) were farmers and 83% had diabetes mellitus. A skin/soft tissue abscess was the most common primary clinical presentation (13/49; 27%), followed by septic arthritis (10/49; 20%), pneumonia, and a deep-seated abscess/organ abscess (7/49; 14%). The major challenges to the diagnosis and treatment of melioidosis in Bangladesh are the lack of resources and the lack of awareness of melioidosis. Capacity development programs are urgently required to define the burden of disease and to tackle the mortality rates.

No abstract availableDOI: http://dx.doi.org/10.3329/jom.v14i2.19693 J Medicine 2013, 14(2): 213-217

Background: Non-alcoholic fatty liver disease (NAFLD) is becoming a public health problem with increasing incidence and it has been shown to be associated with diabetes, dyslipidemia, obesity and metabolic syndrome and ultimately puts more than half the world’s population at risk of developing NAFLD/NASH/cirrhosis in the coming decades. The importance of detection of patients with NAFLD is to intervene the associated factors and avoid transformation to more severe forms of the disease.Methods: An observational case control study was carried out at Medicine Department, Dhaka Medical College Hospital (DMCH), Dhaka, during the period of August, 2011 to June, 2012. A total number of 100 consecutive patients and 100 healthy controls was approaches DMCH were enrolled in this study. Out of 100 NAFLD patients only 20 patients gave consent for liver biopsy to see the extent of liver damage.Result: Less physical activity, Obesity, mean blood pressure, Diabetes, TG, TC were significantly (P5) was found in 9(45%) of the NAFLD group.Conclusion: Significant proportion of NAFLD patient suffers from NASH which is alarming and they have potential for the development of advanced liver disease. So recognition of these risk factors in patients of NAFLD can help in early implementation of strategies that halt the progression of this disease. DOI: http://dx.doi.org/10.3329/jom.v14i2.19665 J Medicine 2013, 14(2): 143-148

Bangladesh Journal of Medicine, Vol 24 No 1, 2013, Page 31-34 DOI: http://dx.doi.org/10.3329/bjmed.v24i1.15034

Bangladesh Journal of Medicine, Vol 24 No 1, 2013, Page 10-13 DOI: http://dx.doi.org/10.3329/bjmed.v24i1.15029

Bangladesh Journal of Medicine, Vol 23 No 2, 2012, Page 76-79 DOI: http://dx.doi.org/10.3329/bjmed.v23i2.14990

This descriptive study was done in the Deponment of Physiology. Dhaka Medical College, Dhaka. during the period of January 2008 to December 2008. The objective of the study was to measure pulse and blood pressure in smokers and nonsmoker adult male stroke patients and to find out changes in pulse and blood pressure among the smoker and non-smoker stroke patients. To accomplish this purpose 105 patient of over 20 years of age were selected. They were divided into two groups: Group A consisting of thirty n on-smoker and group B consisting of seven,' five smoker stroke patients. The finding showed that smoking caused no statistical significant difference 1p>0.05) in pulse and systolic blood pressure among she groups. Diastolic blood pressure was significantly higher (p

In the present study. Forced Vital Capacity (PVC) suit estimated in 100 women in Dingo city. For this purpose a total 100 women subjects with age ranged from 25 years to 35 years withow any recent history of respiratory diseases were selected. 75 normal pregnant women as experimental group and 25 healthy non-pregnant women as control. Eiperintemed group included 25 first trimester. 25 second trimester and 25 third trimester of pregnat women. The FVC was estimated by using a automatic spironteter during the first. second and third trimester of pregnant women and also in non-pregnant control. The mean of the measured values of PVC were analysed statistically. The PVC was significantly lower in third trimester of pregnant women than that of non-pregnant women. Again the FVC was significantly haver he third trimester than that of first trimester of pregnant women. There were no statistically significant difference of PVC bentren the nonpregnant and first trimester: ',email the non-pregnant and second trimester; henveen the first trimester and second trimester: and between the second ',integer and third trimester of pregnant women. h may be concluded dun the causes of progressively decreased FVC throughout the pregnancy were most likely to he mechanical effects of progressively increasing uterus that progressively decrease the hum rolume capacity.

The present study was designed to observe ABC and haemoglobin concentration in female table/es. For this purpose, a total member of 60 /oaks. age ranged from 17-38 years. were selected Thirty of them were athletes 101IperillK011eli group) and 30 non-athletes (comrolh Athletes were selected form Dhanonadi Mohan Krira Comptes ad controls fiat students of Dhaka University. ROC man and haemoglobin concentration were measured by electronk reO water method. RBC moot was land significantly lower in athletes than that of controls but Mere was no change in haemoglobin concentration. The reat of the study 'weals that lowered RBC coma was due to mechanical damage of ersahrocytic membrane leading to shortening of mean life span of ROC.

Bangladesh Journal of Medicine, Vol 24 No 1, 2013, Page 35-37 DOI: http://dx.doi.org/10.3329/bjmed.v24i1.15035

Bangladesh Journal of Medicine, Vol 23 No 2, 2012, Page 85 DOI: http://dx.doi.org/10.3329/bjmed.v23i2.14993

 In the present study the partial pressure of carbon dioxide (PaCO 2 ) and bicarbonate ion (HCO 3 - ) in arterial blood was estimated in 32 women in Dhaka city. For this purpose a total 32 women subjects with age ranged from 25 years to 35 years without any recent history of respiratory diseases were selected and divided into 8 healthy non-pregnant women as control and 24 normal pregnant women as experimental group. Experimental group was further divided into 8 first trimester, 8 second trimester & 8 third trimester of pregnant women. The PaCO 2 and HCO 3 - were estimated by using "Easy Blood Gas Auto Analyzer". The PaCO 2 and HCO 3 - were estimated during the 1st, 2nd, 3rd trimesters of pregnant women and non-pregnant women. The mean of measured values of PaCO 2 and HCO 3 - were analyzed statistically in relation to 1st, 2nd, 3rd trimesters of pregnant women & non-pregnant women. The PaCO 2 and HCO 3 - were significantly lower in 1st trimester, 2nd trimester & 3rd trimester of pregnant women than that of non-pregnant women. There were no statistically significant difference of PaCO 2 and HCO 3 - between the 1st trimester and 2nd trimester; between the 1st trimester and 3rd trimester; and between the 2nd trimester and 3rd trimester of pregnant women. It may be concluded that the causes of progressively decreased PaCO 2 and HCO 3 - throughout the pregnancy were most likely to be due to effect of progesterone causing hyperventilation. Hyperventilation in pregnancy is due to hypersensitivity of respiratory centre. Due to hyperventilation, there is expelling out CO 2 and HCO 3 - causing decreases PaCO 2 and HCO 3 - during pregnancy. doi: 10.3329/jbsp.v3i0.1788 J Bangladesh Soc Physiol.2008 Dec;(3):13-16.