Bangladesh Medical College

Background: Chronic obstructive pulmonary disease is a major cause of morbidity and mortality worldwide and remains under diagnosed, particularly among smokers. Early detection using spirometry may play a pivotal role to improve clinical outcomes and reduce disease progression. Objectives: To evaluate the role of spirometry in the early diagnosis of COPD among smokers in a tertiary care teaching hospital. Methods: This cross-sectional study involved 150 adult smokers who attended Bangladesh Medical College Hospital, Dhaka, from January 2024 to December 2025. Data were collected on demographic characteristics, smoking history, and occupation. COPD was diagnosed by spirometry based on a post-bronchodilator FEV₁/FVC ratio of less than 0.70. Disease severity was graded according to GOLD criteria. Data were analyzed using SPSS version 15.0 software. Results: The mean age of the participants was 46.8 ± 11.2 years, and 88% were male. COPD was detected in 30.7% of the subjects. A significant association was observed between COPD and smoking exposure (p = 0.013), as well as occupational status (p = 0.027). Most cases were mild to moderate in severity. Approximately 28% of the individuals diagnosed with COPD were asymptomatic. Conclusion: For early detection of COPD among smokers, including those with minimal symptoms spirometry may play an effective tool. To reduce disease burden routine screening among high-risk populations may facilitate timely intervention. Bangladesh Crit Care J September 2026; 14 (2): 104-109

Background The Early Warning Score, including qSOFA, MEWS, and NEWS, has been extensively used for the early diagnosis of sepsis and the prediction of sepsis-related mortality. The utility of these scores in low- and middle-income countries, such as Bangladesh, has not been explored. This study aimed to evaluate and compare these scores for the early diagnosis of sepsis and the prediction of sepsis-related mortality. Methods A cross-sectional study was conducted in the department of internal medicine and intensive care unit (ICU) at Bangabandhu Sheikh Mujib Medical University (BSMMU), currently name as Bangladesh Medical University (BMU) from January 2023 to June 2024. A total of 142 suspected sepsis cases were included in the study based on the selection criteria following consecutive sampling technique. Demographic profile, clinical, and laboratory parameters were recorded and bedside tools-qSOFA, MEWS and NEWS score were calculated at admission. Patients were monitored on day 7 or at the time of release, whichever occurred later, to evaluate outcomes. Results Among the study participants 110 (77.5%) of the participants were suffering from sepsis and 58 (52.7%) patients died of sepsis. Sepsis was more prevalent among older, male and smokers. Mean qSOFA, MEWS and NEWS score significantly higher among those with sepsis and who did not survive. NEWS (≥ 8.0) showed best diagnostic performance with 88.18% sensitivity and 90.62% specificity and MEWS (≥ 8.0) had highest accuracy with 67.24% sensitivity and 80.77% specificity for mortality prediction. Conclusion NEWS was most accurate for sepsis diagnosis, and MEWS was superior for predicting in-hospital mortality in sepsis in Bangladesh.

Background: Women with a prior history of Gestational Diabetes Mellitus (GDM) have significantly higher risk of developing metabolic syndrome (MetS), and cardiovascular disease (CVD) compared with women who had normoglycemic pregnancy. Although, several criteria exist for defining MetS, a single biochemical marker is yet to be established to diagnose MetS. Triglyceride-glucose (TyG) index is a simple and cost-effective tool that has recently gained attention as a useful diagnostic marker for metabolic syndrome. Nevertheless, data regarding the utility of TyG index as a diagnostic marker of MetS among women with past history of GDM remain scarce. Objective: Aim of the study was to evaluate TyG index as a diagnostic marker of metabolic syndrome among women with past history of GDM and to correlate TyG index with HOMA-IR and HbA1c. Methods: This retrospective cohort study included 101 women with a history of GDM and 101 women without GDM. They were investigated for fasting glucose, fasting lipid profile, HbA1c and fasting insulin after at least 5 years after the index pregnancy. MetS was diagnosed using International Diabetes Federation (IDF) criteria. Triglyceride-glucose (TyG) index was calculated by Ln (TG [mg/dl] × glucose [mg/dl] / 2). Result: TyG index was significantly higher in prior GDM group compared to Normal glucose tolerance (NGT) group [4.81 vs. 4,63, p<001]. ROC curve to determine the diagnostic accuracy of TyG index for the presence of MetS showed that Area Under Curve (AUC) was 0.84 (95% CI 0.75-0.93, p<001). Cut-off value for MetS among women with history of GDM in case of TYG index was 4.79 (sensitivity 77.3%, specificity 82.9%). TyG index had moderate positive correlation with HOMA-IR (rs 0.48, p<001) and HbA1c (rs 0.41, p<001). Conclusion: TyG index is a good discriminant of MetS and can be a useful biochemical marker for MetS among women with previous history of GDM. [J Assoc Clin Endocrinol Diabetol Bangladesh, 2026;5(Suppl 1): S37]

Objectives To assess the experiences of intern physicians in Bangladesh and identify factors associated with different domains of internship experience. Design Cross-sectional study. Setting Five government and four private medical college hospitals of Bangladesh. Participants 575 intern physicians. Primary and secondary outcomes Internship experiences measured by the Medical Internship Experience Scale (MIES). Domain-specific and total MIES scores were calculated, with higher scores indicating more favourable experiences. Results Overall, mean MIES score was 3.2 (SD 0.6; range 1.2-5.0) with higher scores in job satisfaction (3.8, SD 0.8; range 1-5), clinical learning (3.6, SD 0.7; range 1-5) and fairness and discrimination (3.6, SD 1.1; range 1-5) and lower scores in patient safety (3.2, SD 0.8; range 1-5), stress and burnout (2.5, SD 0.9; range 1-5) and mental well-being (2.6, SD 1.1; range 1-5). Longer internship duration was associated with higher clinical learning (beta=0.06, 95% CI 0.03 to 0.08) and fairness scores (beta=0.05, 95% CI 0.01 to 0.09). Patient safety scores were higher in private medical colleges (beta=0.45, 95% CI 0.28 to 0.62). Female interns had higher stress and burnout (beta=-0.27, 95% CI -0.43 to -0.10) and lower mental well-being (beta=-0.28, 95% CI -0.49 to -0.08). Conclusions Intern physicians in Bangladesh reported favourable experiences in clinical learning and job satisfaction, but less favourable experiences in patient safety, stress and burnout, and mental well-being.